Robot-assisted and open resections for perihilar cholangiocarcinoma. Comparative analysis of the immediate outcomes

2020 ◽  
Vol 25 (4) ◽  
pp. 60-70
Author(s):  
M. G. Efanov ◽  
R. B. Alikhanov ◽  
I. V. Kazakov ◽  
A. N. Vankovich ◽  
O. V. Melekhina ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Extrahepatic Bile Duct ◽  
Radical Resection ◽  
Vascular Reconstruction ◽  
Perihilar Cholangiocarcinoma ◽  
Initial Experience ◽  
Robot Assisted ◽  
Bile Duct Resection ◽  
Single Center Experience ◽  
Extrahepatic Bile Duct Resection

Background. Minimally invasive radical surgery for perihilar cholangiocarcinoma is in its early stages. Aim. A comparative analysis of the initial experience of robot-assisted and open resections for perihilar cholangiocarcinoma. Material and methods. The single-center experience, accumulated over the period from 2014 to 2018, is analyzed. Robot-assisted procedures included major liver resection and caudate lobectomy with extrahepatic bile duct resection and lymphadenectomy. The need for vascular reconstruction was considered a contraindication to surgery. Results. Thirteen robot-assisted resections were performed. The perihilar cholangiocarcinoma was confirmed by pathologic examination in 10 patients. The immediate outcomes were compared with that in 88 open procedures. There were no significant differences in blood loss, the rate of severe morbidity, mortality, and hospital stay. The duration of the robot-assisted surgical resections was significantly longer. Conclusion. Analysis of initial experience justifies the robotic approach for radical resection in highly selected patients.

Indication of extrahepatic bile duct resection for gallbladder cancer

2017 ◽  
Vol 403 (1) ◽  
pp. 45-51 ◽  
Author(s):  
Hiroshi Kurahara ◽  
Kosei Maemura ◽  
Yuko Mataki ◽  
Masahiko Sakoda ◽  
Satoshi Iino ◽  
...  
Keyword(s):  
Bile Duct ◽  
Gallbladder Cancer ◽  
Extrahepatic Bile Duct ◽  
Bile Duct Resection ◽  
Extrahepatic Bile Duct Resection

scholarly journals A case with massive hemobilia long-term after internal drainage surgery for congenital biliary dilation

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Shunryo Minezaki ◽  
Takeyuki Misawa ◽  
Makoto Watanabe ◽  
Hideki Takahashi ◽  
Takashi Koenuma ◽  
...  
Keyword(s):  
Bile Duct ◽  
Gastrointestinal Bleeding ◽  
Pathological Condition ◽  
Extrahepatic Bile Duct ◽  
Pathological Examination ◽  
Emergency Setting ◽  
Internal Drainage ◽  
Bile Duct Resection ◽  
Extrahepatic Bile Duct Resection ◽  
Life Threatening

Abstract Background Currently, there is an unwavering consensus that the standard surgery for congenital biliary dilation (CBD) is extrahepatic bile duct resection and choledochojejunostomy. However, decades prior, choledochocyst–gastrointestinal anastomosis without extrahepatic bile duct resection (internal drainage surgery, IDS) was preferred for CBD because of its simplicity. Currently, there is almost no chance of a surgeon encountering a patient who has undergone old-fashioned IDS, which has been completely obsolete due to the risk of carcinogenesis from the remaining bile duct. Moreover, the pathological condition long after IDS is unclear. Herein, we report a case of life-threatening bile duct bleeding as well as carcinoma of the bile duct 62 years after IDS in a patient with CBD. Case presentation An 82-year-old Japanese woman with hemorrhagic shock due to gastrointestinal bleeding was transferred to our hospital. She had a medical history of unspecified surgery for CBD at the age of 20. Based on imaging findings and an understanding of the historical transition of the surgical procedure for CBD, the cause of gastrointestinal bleeding was determined to be rupture of the pseudoaneurysm of the dilated bile duct that remained after IDS. Hemostasis was successfully performed by transcatheter arterial embolization (TAE) in an emergency setting. Then, elective surgery for extrahepatic bile duct resection and choledochojejunostomy was performed to prevent rebleeding. Pathological examination revealed severely and chronically inflamed mucosa of the bile duct. Additionally, cholangiocarcinoma (Tis, N0, M0, pStage 0) was incidentally revealed. Conclusion It has been indicated that not only carcinogenesis, but also a risk of life-threatening bleeding exists due to long-lasting chronic inflammation to the remnant bile duct after IDS for CBD. Additionally, both knowledge of which CBD operation was performed, and an accurate clinical history are important for the diagnosis of hemobilia.

606 Pass the Courvoisier's: Laparoscopic Extrahepatic Bile Duct Resection With Roux-en-Y Hepaticojejunostomy

2013 ◽  
Vol 144 (5) ◽  
pp. S-1057
Author(s):  
Rebecca Kowalski ◽  
Niket Sonpal ◽  
Jennifer Montes ◽  
Paresh C. Shah
Keyword(s):  
Bile Duct ◽  
Extrahepatic Bile Duct ◽  
Bile Duct Resection ◽  
Extrahepatic Bile Duct Resection

scholarly journals Robot-Assisted Laparoscopic Resection of a Todani Type II Choledochal Malformation

2019 ◽  
Vol 13 (2) ◽  
pp. 230-237 ◽  
Author(s):  
Anneke ten Hove ◽  
Ruben H.J. de Kleine ◽  
Maarten W. Nijkamp ◽  
Annet S.H. Gouw ◽  
Timco Koopman ◽  
...  
Keyword(s):  
Laparoscopic Resection ◽  
Extrahepatic Bile Duct ◽  
Squamous Metaplasia ◽  
Biliary Tree ◽  
Type Ii ◽  
Robot Assisted ◽  
Cyst Excision ◽  
Extrahepatic Bile Duct Resection ◽  
Different Types ◽  
Choledochal Malformation

Choledochal malformation (CM) comprise various congenital cystic dilatations of the extrahepatic and/or intrahepatic biliary tree. CM is classified into five different types. Our case describes a 58-year-old man presenting with acute abdominal pain. Further examination showed a Todani type II CM. Treatment for type II is complete cyst excision without the need for an extrahepatic bile duct resection. A robot-assisted laparoscopic resection of the CM was performed and the patient recovered without complications. Pathology results showed a Todani type II malformation in which complete squamous metaplasia has occurred. In this paper, we report, to the best of our knowledge, the first description of a robot-assisted laparoscopic resection of a type II CM.

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