A New Era of Bile Duct Repair: Robotic-Assisted Versus Laparoscopic Hepaticojejunostomy
| Autor: | Eduardo Cárdenas-Lailson, Orlando Bada-Yllán, Carlos Ernesto Morales-Chávez, Mucio Moreno-Portillo, Adolfo Cuendis-Velázquez, Martín Edgardo Rojano-Rodríguez, Carlos Valenzuela-Salazar, Sujey Romero-Loera, Mario Trejo-Avila, Luis Fernández-Álvarez |
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| Rok vydání: | 2018 |
| Předmět: |
Laparoscopic surgery
Adult Male medicine.medical_specialty Robotic assisted medicine.medical_treatment Jejunostomy 03 medical and health sciences 0302 clinical medicine Postoperative Complications Robotic Surgical Procedures Medicine Humans Robotic surgery In patient Cholecystectomy Retrospective Studies business.industry Bile duct Mortality rate Anastomosis Surgical Gastroenterology Middle Aged Surgery medicine.anatomical_structure Injury types Liver 030220 oncology & carcinogenesis Invasive surgery 030211 gastroenterology & hepatology Female Laparoscopy Bile Ducts business |
| Zdroj: | Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract. 23(3) |
| ISSN: | 1873-4626 |
| Popis: | Despite scientific evidence of the safety, efficacy, and in some cases superiority of minimally invasive surgery in hepato-pancreato-biliary procedures, there are scarce publications about bile duct repairs. The aim of this study was to compare the outcomes of robotic-assisted surgery versus laparoscopic surgery on bile duct repair in patients with post-cholecystectomy bile duct injury. This is a retrospective comparative study of our prospectively collected database of patients with bile duct injury who underwent robotic or laparoscopic hepaticojejunostomy. Seventy-five bile duct repairs (40 by laparoscopic and 35 by robotic-assisted surgery) were treated from 2012 to 2018. Injury types were as follows: E1 (7.5% vs. 14.3%), E2 (22.5% vs. 14.3%), E3 (40% vs. 42.9%), E4 (22.5% vs. 28.6%), and E5 (7.5% vs. 0), for laparoscopic hepaticojejunostomy (LHJ) and robotic-assisted hepaticojejunostomy (RHJ) respectively. The overall morbidity rate was similar (LHJ 27.5% vs. RHJ 22.8%, P = 0.644), during an overall median follow-up of 28 (14–50) months. In the LHJ group, the actuarial primary patency rate was 92.5% during a median follow-up of 49 (43.2–56.8) months. While in the RHJ group, the actuarial primary patency rate was 100%, during a median follow-up of 16 (12-22) months. The overall primary patency rate was 96% (LHJ 92.5% vs. RHJ 100%, log-rank P = 0.617). Our results showed that the robotic approach is similar to the laparoscopic regarding safety and efficacy in attaining primary patency for bile duct repair. |
| Databáze: | OpenAIRE |
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