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Review
. 2022 Feb 18;14(4):1046.
doi: 10.3390/cancers14041046.

Robotic Surgery for Biliary Tract Cancer

Lyonell B Kone  1 , Philip V Bystrom  1 , Ajay V Maker  2
Affiliations
Review

Robotic Surgery for Biliary Tract Cancer

Lyonell B Kone et al. Cancers (Basel). .

Abstract

Biliary tract cancer consists of cholangiocarcinoma (CC) and gallbladder cancer (GBC). When resectable, surgery provides the best chance at long-term survival. Unfortunately, surgery for these tumors is associated with long operative times, high morbidities, and prolonged hospital stays. Minimally invasive surgery has been shown to impact selected outcomes, including length of stay, in other diseases, and robotic surgery may offer additional advantages compared to laparoscopic surgery in treating bile duct cancers. This is a systematic review of robotic surgery for biliary tract cancer. Predetermined selection criteria were used to appraise the literature. The PRISMA guidelines were followed. In total, 20 unique articles with a total of 259 patients with biliary tract cancer undergoing robotic surgery met the inclusion criteria. For CC and GBC, respectively, the weighted average operative time was 401 and 277 min, the estimated blood loss was 348 and 260 mL, the conversion rate to open was 7 and 3.5%, the all-cause morbidity was 52 and 9.7%, the major morbidity was 12 and 4.4%, the perioperative mortality was 1.4 and 0%, the length of stay was 15 and 4.8 days, the positive margin rate was 27 and 9%, and the number of lymph nodes retrieved was 4.2 and 8. Robotic surgery for biliary tract cancer appears non-inferior to open surgery when compared to the published contemporary data. However, the current literature on the topic is of low quality, and future prospective/randomized studies are needed.

Keywords: biliary tract cancer; cholangiocarcinoma; gallbladder cancer; klatskin tumor; minimally invasive surgery; robotic surgery.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram of study selection process. In total, 20 unique studies were selected, with 1 study meeting the selection criteria for both cholangiocarcinoma and gallbladder cancer.
Figure 2
Figure 2
Meta-analysis of robotic vs. open surgery for radical cholecystectomy. (A) Operative time in minutes; (B) Estimated Blood Loss in ml; (C) Length of hospital stay in days.
Figure 3
Figure 3
Traffic light plots of Joanna Briggs Institute critical appraisal for case series (A) and case reports (B) using the Robvis tool which provides copyright permission for publication of created figures [8].
See this image and copyright information in PMC

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