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Review
. 2023 Dec 21;14(1):12.
doi: 10.3390/jpm14010012.

Robotic Hepatectomy plus Biliary Reconstruction for Bismuth Type III and Type IV Hilar Cholangiocarcinoma: State of the Art and Literature Review

Simone Guadagni  1 , Annalisa Comandatore  1 , Niccolò Furbetta  1 , Gregorio Di Franco  1 , Cristina Carpenito  1 , Bianca Bechini  1 , Filippo Vagelli  1 , Niccolò Ramacciotti  1 , Matteo Palmeri  1 , Giulio Di Candio  1 , Luca Morelli  1   2
Affiliations
Review

Robotic Hepatectomy plus Biliary Reconstruction for Bismuth Type III and Type IV Hilar Cholangiocarcinoma: State of the Art and Literature Review

Simone Guadagni et al. J Pers Med. .

Abstract

Background: In Bismuth type III and IV Hilar Cholangiocarcinoma (III-IV HC), surgical resection is the only chance for long-term survival. As the surgical procedure is complex and Robotic-Assisted Surgery (RAS) may be particularly suitable in this setting, the aim of this study is to evaluate the potential benefits of RAS in III-IV HC in terms of post-operative outcomes.

Methods: We conducted a systematic review using the PRISMA checklist for article selection. We searched the PubMed database and included only studies with clinical data about the treatment of III-IV HC using RAS.

Results: A total of 12 papers involving 50 patients were included. All cases were Bismuth IIIa (n = 18), IIIb (n = 27) or IV type (n = 5) and underwent hepatectomy with biliary confluence resection and reconstruction. The mean operative time was 500 minutes with a conversion rate of 4%. The mean hospital stay was 12.2 days, and the morbidity and 30-day mortality rate were 61.9% and 2%, respectively. Over a mean follow up period of 10.1 months, 9/18 cases experienced recurrence (50%).

Conclusions: RAS for III-IV HC is safe and feasible, at least if performed by experienced surgeons on selected cases. The oncological outcomes appear acceptable, given the aggressiveness of this pathology, but further studies are needed to fully elucidate the exact role of robotics in this setting.

Keywords: Hilar Cholangiocarcinoma; da Vinci; robotic liver resection.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram for our systematic reviews.
See this image and copyright information in PMC

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