Abstract
Background: Carcinoma of the gallbladder (GBC) is the most common malignancy of the extra-biliary tract. The only potentially curative option for patients is radical resection. However, minimally invasive surgery for GBC has traditionally been discouraged. Purpose and method: The aim of this study is to describe our technique step-by-step for the Robotic-assisted surgical treatment of GBC. Clinical case: A 75-year-old woman presented to the outpatient clinic follow-up. Her medical history was notable for a recent sigmoidectomy for colorectal carcinoma. A routine hematological test was unremarkable including a Ca19-9 value of 20.6 UI/mL. An abdominal Computed Tomography revealed the presence of a gallbladder lesion was about 33 mm. A Magnetic Resonance confirmed the suspicion. The patient underwent to surgery through our DaVinci Xi Surgical System. Radical resection was carried-out including the gallbladder bed, common bile duct and lymphadenectomy. The hospital stay was uneventful and the patient was discharged on the sixth post-operative day. The pathologist reported a GBC with only metastasis in the cystic lymph node, there were no malignancy in the liver nor the common bile duct (pT2N1). Conclusion: Even though endoscopic approach for GBC has long been contraindicated, few recent studies have demonstrated correct oncologic outcomes. We present a Robot-assisted radical resection for GBC demonstrating its feasibility and safety. Minimally invasive techniques have emerged as a promising way to reduce time for recovery of patients with similar oncological results. The long-term results contrasting open versus endoscopic approaches are needed.
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