Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2025 Jul 1;160(7):755-762.
doi: 10.1001/jamasurg.2025.1291.

Clinical Outcomes of Laparoscopic vs Robotic-Assisted Cholecystectomy in Acute Care Surgery

Nathnael Abera Woldehana  1   2   3 , Andrew Jung  1 , Brett Colton Parker  1 , Alisa Mae Coker  1 , Elliott Richard Haut  4   5   6   7 , Gina Lynn Adrales  1
Affiliations
Comparative Study

Clinical Outcomes of Laparoscopic vs Robotic-Assisted Cholecystectomy in Acute Care Surgery

Nathnael Abera Woldehana et al. JAMA Surg. .

Abstract

Importance: The use of robotic-assisted cholecystectomy in acute care surgery is increasing, but its safety and efficacy compared with laparoscopic cholecystectomy remain unclear.

Objective: To compare clinical outcomes and bile duct injury rates between robotic-assisted cholecystectomy and laparoscopic cholecystectomy in acute care surgery.

Design, setting, and participants: This was a retrospective cohort study using patient data from a commercial claims and encounter database from 2016 to 2021. Included in the study were adult patients undergoing robotic-assisted cholecystectomy or laparoscopic cholecystectomy in acute care surgery. Data were analyzed from January to October 2024.

Exposures: Robotic-assisted or laparoscopic cholecystectomy in acute care surgery.

Main outcomes and measures: The primary outcome was bile duct injury.

Results: A total of 844 428 patients (mean [SD] age, 45.6 [12.5] years; 547 665 female [64.9%]) were included in this analysis. After propensity score matching, robotic-assisted cholecystectomy (n = 35 037) and laparoscopic cholecystectomy (n = 35 037) had similar bile duct injury rates (0.37% [128 of 35 037] vs 0.39% [138 of 35 037]; odds ratio [OR], 0.93; 95% CI, 0.73-1.18; P = .54). Robotic-assisted cholecystectomy had higher major postoperative complications (8.37% [2934 of 35 037] vs 5.50% [1926 of 35 037]; OR, 1.57; 95% CI, 1.48-1.67; P < .001), more postoperative drain use (0.63% [219 of 35 037] vs 0.48% [132 of 35 037]; OR, 1.66; 95% CI, 1.34-2.07; P < .001), and longer median (IQR) hospital length of stay (3 [2-4] days vs 2 [1-4] days; P < .001).

Conclusions and relevance: In this large, propensity-matched cohort analysis of acute care surgery cholecystectomy, robotic-assisted and laparoscopic cholecystectomy had similar bile duct injury rates, but robotic-assisted cholecystectomy was associated with higher postoperative complications, longer hospital stays, and increased drain use. Further research is needed to optimize the use of robotic-assisted cholecystectomy for acute gallbladder disease. These findings suggest that, under current practice conditions, robotic-assisted cholecystectomy may not offer clear benefits compared with the standard, established laparoscopic cholecystectomy approach.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosures: Dr Jung reported receiving conference travel/attendance support from Intuitive Surgical outside the submitted work. Dr Parker reported receiving consulting fees from Merit Medical. Dr Coker reported receiving speaker/consulting fees from Intuitive Surgical outside the submitted work. Dr Haut reported receiving grants from Patient-Centered Outcomes Research Institute (PCORI), Agency for Healthcare Research and Quality (AHRQ), and the National Institutes of Health (NIH)/National Heart, Lung, and Blood Institute (NHLBI) outside the submitted work. Dr Haut reported receiving grants from AHRQ, PCORI, and NIH/NHLBI outside the submitted work. Dr Adrales reported receiving advisory board fees from Johnson and Johnson and Ethicon, speaker fees from TELA Bio, and consulting fees from Caresyntax outside the submitted work. No other disclosures were reported.

References

    1. Sheetz KH, Claflin J, Dimick JB. Trends in the adoption of robotic surgery for common surgical procedures. JAMA Netw Open. 2020;3(1):e1918911. doi: 10.1001/jamanetworkopen.2019.18911 - DOI - PMC - PubMed
    1. Kalata S, Thumma JR, Norton EC, Dimick JB, Sheetz KH. Comparative safety of robotic-assisted vs laparoscopic cholecystectomy. JAMA Surg. 2023;158(12):1303-1310. doi: 10.1001/jamasurg.2023.4389 - DOI - PMC - PubMed
    1. Lunardi N, Abou-Zamzam A, Florecki KL, et al. Robotic technology in emergency general surgery cases in the era of minimally invasive surgery. JAMA Surg. 2024;159(5):493-499. doi: 10.1001/jamasurg.2024.0016 - DOI - PMC - PubMed
    1. Campbell S, Lee SH, Liu Y, Wren SM. A retrospective study of laparoscopic, robotic-assisted, and open emergent/urgent cholecystectomy based on the PINC AI Healthcare Database 2017. World J Emerg Surg. 2023;18(1):55. doi: 10.1186/s13017-023-00521-8 - DOI - PMC - PubMed
    1. Lee SJ, Moon JI, Choi IS. Robotic single-site cholecystectomy is better in reducing postoperative pain than single-incision and conventional multiport laparoscopic cholecystectomy. Surg Endosc. 2023;37(5):3548-3556. doi: 10.1007/s00464-022-09846-y - DOI - PubMed

Publication types

LinkOut - more resources