Hooda Zamaan, Dong Deanna, Hlayhel Ahmad, Bustamante John Paul, Veltri John, Yanagawa Franz, Talishinskiy Toghrul, Moszczynski Zbigniew, Christian Derick, Abaijan Sydney, Rebein Benjamin, Sori Alan, Wessner Scott
Department of Surgery, St. Joseph's University Medical Center, Paterson, NJ. (Drs. Hooda, Hlayhel, Bustamante, Veltri, Yanagawa, Talishinskiy, Christian, Abaijan, Wessner, Rebein, and Sori).
Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, TX. (Dr. Hooda).
JSLS. 2025 Apr-Jun;29(2). doi: 10.4293/JSLS.2025.00026. Epub 2025 May 7.
Although laparoscopic cholecystectomy (LC) is considered the gold standard surgical approach for acute cholecystitis, there has been increased interest in robotic-assisted cholecystectomy (RAC) as an alternative treatment method. This study compares length of operative time and perioperative outcomes between these 2 techniques.
We identified patients from a single institution between January 1, 2023 and December 31, 2023, who underwent surgical treatment for acute cholecystitis. Gathered data included demographic, clinicopathologic, and perioperative variables. Patients were stratified by LC or RAC surgical approaches. Pearson χ, Fisher's exact, Mann-Whitney , and unpaired tests were utilized to compare collected variables.
We identified 259 total patients, with 186 patients in the LC group (71.8%) and 73 in the RAC group (28.2%). Females comprised most both groups (LC, n = 125/186, 67.2%; RAC, n-n = 48/73, 65.8%, = .884). Median age at surgery for LC patients was 43 years, and 49 for RAC patients ( = .341). As for operative time, the median duration for LC was 108 minutes and 68.2 minutes for RAC ( < .001). Nine LC (4.8%) patients and 1 RAC (1.4%, = .192) had postoperative complications. Conversion to open or fenestrated cholecystectomy occurred in 8 LC (4.3%) patients and 4 RAC (5.5%, = .745) patients.
This study demonstrated that RAC has a shorter operative duration in comparison to LC. RAC also has a similar rate of complications and conversions as the laparoscopic approach. Our findings show that RAC is a safe and feasible alternative approach for treating acute cholecystitis.
尽管腹腔镜胆囊切除术(LC)被认为是急性胆囊炎的金标准手术方法,但作为一种替代治疗方法,机器人辅助胆囊切除术(RAC)越来越受到关注。本研究比较了这两种技术的手术时间和围手术期结果。
我们确定了2023年1月1日至2023年12月31日期间在单一机构接受急性胆囊炎手术治疗的患者。收集的数据包括人口统计学、临床病理和围手术期变量。患者按LC或RAC手术方法分层。采用Pearson χ²检验、Fisher精确检验、Mann-Whitney检验和不成对t检验来比较收集到的变量。
我们共确定了259例患者,其中LC组186例(71.8%),RAC组73例(28.2%)。两组中女性占大多数(LC组,n = 125/186,67.2%;RAC组,n = 48/73,65.8%,P = 0.884)。LC组患者手术时的中位年龄为43岁,RAC组为49岁(P = 0.341)。至于手术时间,LC组的中位时长为108分钟,RAC组为68.2分钟(P < 0.001)。9例LC患者(4.8%)和1例RAC患者(1.4%,P = 0.192)出现术后并发症。8例LC患者(4.3%)和4例RAC患者(5.5%,P = 0.745)转为开腹或开窗胆囊切除术。
本研究表明,与LC相比,RAC的手术时间更短。RAC的并发症发生率和中转率与腹腔镜手术方法相似。我们的研究结果表明,RAC是治疗急性胆囊炎的一种安全可行的替代方法。