Jang Eun Jeong, Kim Kwan Woo
Department of Surgery, Dong-A University Medical Center, Dong-A University College of Medicine, Busan, Korea.
J Minim Invasive Surg. 2025 Jun 15;28(2):103-107. doi: 10.7602/jmis.2025.28.2.103.
Hepatopancreatoduodenectomy (HPD) is a definitive, yet highly complex surgical approach for treating extensive cholangiocarcinoma, characterized by substantial morbidity and mortality. Recent advancements in minimally invasive surgery, particularly robotic platforms, have demonstrated potential in overcoming the technical challenges associated with HPD. Here, we present a case of a 69-year-old male with hilar cholangiocarcinoma extending to the mid and distal common bile duct, successfully managed with robotic left hepatectomy, caudate lobectomy, and pancreaticoduodenectomy (HPD). The operation, performed using the da Vinci Xi system (Intuitive Surgical), lasted 543 minutes with an estimated blood loss of 500 mL. Postoperative complications, including a hepaticojejunostomy leakage, were managed conservatively, and the patient was discharged. This case highlights the feasibility and safety of robotic HPD for complex biliary malignancies, emphasizing its potential as a minimally invasive alternative in select patients when performed by experienced surgeons.
肝胰十二指肠切除术（HPD）是一种用于治疗广泛性胆管癌的确定性但高度复杂的手术方法，其特点是发病率和死亡率较高。微创手术，尤其是机器人平台的最新进展，已显示出在克服与HPD相关的技术挑战方面的潜力。在此，我们报告一例69岁男性肝门部胆管癌累及胆总管中下段的病例，该病例通过机器人辅助左半肝切除术、尾状叶切除术和胰十二指肠切除术（HPD）成功治疗。手术使用达芬奇Xi系统（直观外科公司）进行，持续543分钟，估计失血量为500毫升。术后并发症包括肝空肠吻合口漏，经保守治疗后患者出院。该病例突出了机器人辅助HPD治疗复杂胆道恶性肿瘤的可行性和安全性，强调了在经验丰富的外科医生操作下，它作为某些患者微创替代方案的潜力。
