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对于合并症负担较高的患者群体,无论是择期还是急诊情况下,机器人胆囊切除术对于所有胆囊病变程度都是安全有效的:来自纽约东弗拉特布什的结果。

Robotic cholecystectomy is safe and effective for all levels of gallbladder pathology in both the elective and emergent setting in a patient population with a high comorbidity load: outcomes from East Flatbush, New York.

作者信息

Crehan Shannon, Ahmed Mohamed Ali, Morin Nicholas

机构信息

General Surgery Department, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA.

Kings County Medical Center, General Surgery Department, East Flatbush, NY, USA.

出版信息

J Robot Surg. 2025 Aug 2;19(1):444. doi: 10.1007/s11701-025-02620-x.

Abstract

The value of using the Da Vinci robotic platform to perform a cholecystectomy is still under investigation, particularly within emergent settings. The aim of our study is to analyze the safety, efficacy, and clinical outcomes associated with robotic cholecystectomy among patients with a high comorbidity load, comparative health disparities, and varying degrees of gallbladder pathology. To measure and compare 30-day postoperative complications seen in the robot-assisted cholecystectomy in a patient population with a high comorbidity load. We conducted a single-institution, retrospective analysis of a total of 218 patients who underwent either an elective or emergent robotic cholecystectomy from June 2020 to October 2023. All cases were performed at a tertiary care hospital by four surgeons with varying levels of robotic experience, ranging from 25 to 7 years of robotic experience. Baseline preoperative demographics, comorbidities, severity of gallbladder pathology, and 30-day clinical outcomes were recorded. Of the 218 patients, 94 were emergent and 124 were elective. All had varying degrees of gallbladder pathology. The emergent cases were significantly more likely to have severe pathological findings compared to the elective cases. The overall complication rate in our population was 7.3%. The most common complications were postoperative sickle cell crisis, hepatic abscess, and incisional seroma. No bile duct injuries were encountered, and minimal 30-day outcomes were observed. In both elective and emergent settings, robotic cholecystectomy is safe and effective in a patient population with a high comorbidity load, health disparities, and varying degrees of gallbladder pathology.

摘要

使用达芬奇机器人平台进行胆囊切除术的价值仍在研究中,尤其是在急诊情况下。我们研究的目的是分析在合并症负担高、存在健康差异以及胆囊病变程度不同的患者中,机器人辅助胆囊切除术的安全性、有效性和临床结果。以测量和比较在合并症负担高的患者群体中,机器人辅助胆囊切除术后30天的并发症情况。我们对2020年6月至2023年10月期间共218例行择期或急诊机器人辅助胆囊切除术的患者进行了单机构回顾性分析。所有病例均在一家三级护理医院由四名机器人经验水平不同(机器人经验从25年到7年不等)的外科医生进行。记录了术前基线人口统计学数据、合并症、胆囊病变严重程度以及30天临床结果。在218例患者中,94例为急诊手术,124例为择期手术。所有患者均有不同程度的胆囊病变。与择期病例相比,急诊病例出现严重病理结果的可能性显著更高。我们研究人群的总体并发症发生率为7.3%。最常见的并发症是术后镰状细胞危象、肝脓肿和切口血清肿。未发生胆管损伤,观察到的30天结果轻微。在择期和急诊情况下,机器人辅助胆囊切除术对于合并症负担高、存在健康差异以及胆囊病变程度不同的患者群体来说都是安全有效的。

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