Early outcomes of robotic extended cholecystectomy for the treatment of gallbladder cancer

J Hepatobiliary Pancreat Sci. 2020 Jun;27(6):324-330. doi: 10.1002/jhbp.717. Epub 2020 Feb 15.

Abstract

Background: Simple laparoscopic cholecystectomy is sufficient for patients with early gallbladder cancer (GBC). However, because advanced GBCs of T2 or more advanced stages require more complex procedures such as liver resection and lymph node dissection, minimally invasive surgery (MIS) has not been popularized. To evaluate the applicability of MIS for GBC, we report the early outcomes of robotic extended cholecystectomies (RECs).

Methods: Thirteen patients who radiologically suspected to have T2 or more advanced stages of GBC underwent REC from February 2018 to April 2019. Thirty-nine patients who underwent open extended cholecystectomy were selected by 1:3 propensity score matching, and the differences of clinicopathologic features according to surgical methods were analyzed.

Results: Compared with open method, operation time, estimated blood loss, postoperative complication rate, and number of retrieved lymph nodes were not significantly different. In REC group, duration of hospital stay was shorter (6.6 vs 8.3 days, P = .002) and postoperative pain was significantly lower in the REC group (P = .024).

Conclusion: The early outcomes of REC were favorable with regard to early recovery and less pain, with similar number of retrieved lymph nodes. REC is a promising option for treatment of GBC, but further long-term survival studies are needed.

Keywords: gallbladder cancer; minimally invasive surgical procedures; robotic extended cholecystectomy; robotic surgical procedures.

MeSH terms

  • Aged
  • Cholecystectomy / methods*
  • Female
  • Gallbladder Neoplasms / diagnostic imaging
  • Gallbladder Neoplasms / pathology
  • Gallbladder Neoplasms / surgery*
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Pain Measurement
  • Pain, Postoperative / epidemiology
  • Propensity Score
  • Republic of Korea
  • Robotic Surgical Procedures*