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Minimally invasive surgery for choledochal cysts: Laparoscopic versus robotic approaches

 Jong Hwi Yoon  ;  Ho Kyoung Hwang  ;  Woo Jung Lee  ;  Chang Moo Kang 
 Annals of Hepato-biliary-pancreatic Surgery, Vol.25(1) : 71-77, 2021-02 
Journal Title
 Annals of Hepato-biliary-pancreatic Surgery 
Issue Date
Choledochal cyst ; Laparoscopy ; Robotic surgical procedure
Backgrounds/aims: Minimally invasive surgery is a widely accepted approach in hepatobiliary surgery and choledochal cyst excision has also been performed by minimally invasive methods, including laparoscopic and robotic approaches. However, only a few studies have compared laparoscopic and robotic surgery. Therefore, we performed a comparative study between two groups, including cost aspects. Methods: We retrospectively analyzed minimally invasive choledochal cyst excision at Severance Hospital in Seoul, South Korea from January 2005 to December 2018. A total of 39 patients that underwent minimally invasive choledochal cyst excision were identified. The 23 patients (58.9%) and 16 patients (41.1%) were enrolled in laparoscopic and robotic approach, respectively. We compared the patient's characteristics, and perioperative outcomes between laparoscopic and robotic surgery groups. Results: A comparative analysis between the two groups showed no differences in preoperative clinical characteristics. There were no significant differences in operative time, estimated blood loss, and postoperative complications, including biliary complication. The preoperative ASA score (p=0.021) and hospital stays (p=0.011) were the only clinical variables that differed between the two groups. All of the variables included in the cost analysis showed statistically significant differences (total hospital charge: p=0.035, patient's bill: p≤0.001, operation: p=0.002, anesthesia: p=0.001, postoperative management: p=0.001). Conclusions: The overall clinical outcomes between the laparoscopic and robotic approach to choledochal cyst were comparable. The surgical approach should be balanced based on the surgeons' skill, patients' general condition, disease extent, and economic status.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Hwang, Ho Kyoung(황호경) ORCID logo https://orcid.org/0000-0003-4064-7776
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