Robotic radical cholecystectomy for gallbladder adenocarcinoma experience from a single tertiary referral center

Abstract

Presenter: Tara Hughes MD | University of Mississippi Medical Center Background: The scope of abdominal surgical procedures performed with utilization of robotic systems has expanded substantially in the past several years. There is little available data regarding the safety and adequacy of a robotic radical cholecystectomy. Gallbaldder adenocarcinoma is most commonly diagnosed at an advanced age, and a minimally invasive approach has the potential to significantly improve the morbidity associated with an open operation. We sought to evaluate the surgical outcomes of our experience with robotic resection at our institution. Methods: A retrospective chart review was performed for 5 patients who underwent a robotic radical cholecystectomy at our institution between the dates of January 1, 2018 through December 31, 2020. All patients were incidentally found to have gallbladder adenocarcinoma after undergoing laparoscopic cholecystectomy. We examined surgical outcomes for these patients including operative times, hospital length of stay, estimated blood loss, the number of lymph nodes resected, margins, and complications. Results: All patients successfully underwent a robotic assisted radical cholecystectomy and no patients required conversion to an open procedure. The median length of stay for our patients was 1 day. Operative times were on average 250 minutes. All resections were completed as R0 resections and a median number of 5 lymph nodes were harvested on portal dissection. The average estimated blood loss was 240 ml. There were no complications for any of these patients. Our median follow up post operatively was 3 months. There was one patient diagnosed with local recurrence a year after resection. Conclusion: Our case series demonstrates that robotic radical cholecystectomy is a safe and feasible option for resection of gallbladder adenocarcinoma. The experience at our institution indicates that a robotic approach may lead to a shorter length of stay and reduced morbidity relative to an open approach. Further investigation is warranted to clearly establish adequacy of robotic portal lypmadenectomy and oncologic outcomes.