Comparing Outcomes Between Robotic and Laparoscopic Cholecystectomy for Acute Cholecystitis

Abstract

Introduction: Although laparoscopic cholecystectomy (LC) is considered the gold standard surgical approach for acute cholecystitis, there has been increased interest in robotic-assisted cholecystectomy (RAC) as an alternative treatment method. This study compares length of operative time and perioperative outcomes between these 2 techniques.

Methods: We identified patients from a single institution between January 1, 2023 and December 31, 2023, who underwent surgical treatment for acute cholecystitis. Gathered data included demographic, clinicopathologic, and perioperative variables. Patients were stratified by LC or RAC surgical approaches. Pearson χ², Fisher's exact, Mann-Whitney U, and unpaired t tests were utilized to compare collected variables.

Results: We identified 259 total patients, with 186 patients in the LC group (71.8%) and 73 in the RAC group (28.2%). Females comprised most both groups (LC, n = 125/186, 67.2%; RAC, n-n = 48/73, 65.8%, P = .884). Median age at surgery for LC patients was 43 years, and 49 for RAC patients (P = .341). As for operative time, the median duration for LC was 108 minutes and 68.2 minutes for RAC (P < .001). Nine LC (4.8%) patients and 1 RAC (1.4%, P = .192) had postoperative complications. Conversion to open or fenestrated cholecystectomy occurred in 8 LC (4.3%) patients and 4 RAC (5.5%, P = .745) patients.

Conclusions: This study demonstrated that RAC has a shorter operative duration in comparison to LC. RAC also has a similar rate of complications and conversions as the laparoscopic approach. Our findings show that RAC is a safe and feasible alternative approach for treating acute cholecystitis.

Keywords: Acute cholecystitis; Complications; Fenestrated cholecystectomy; Laparoscopic cholecystectomy; Open cholecystectomy; Operating time; Robotic-assisted cholecystectomy.

Figure 1.

Inclusion and exclusion criteria.

Figure 2.

Unpaired student’s t test results.