Does Robotic Approach in Cholecystectomy Increase the Chance of Bile Duct Injury? an In-Depth Analysis of National Database

Author Type(s)

Faculty

Document Type

Abstract

Publication Date

11-2021

DOI

10.1016/j.jamcollsurg.2021.08.292

Journal Title

Journal of the American College of Surgeons

Department

Surgery

Abstract

Introduction

Minimally invasive techniques is the gold standard in cholecystectomy. Laparoscopic approach has been widely adopted, surgeons in their effort to further improve their skills passed to the era of the robotic assistance.

Methods

We Performed one year analysis of the national readmission database 2017 and included all patients who underwent laparoscopic (LaC) or robotic assisted cholecystectomy (RaC). Primary outcome measures were bile duct injuries. Secondary outcome measures were hospital charges.

Results

We analyzed a total of 160407 patients who underwent either laparoscopic or robotic assisted cholecystectomy. Mean age was 55±19 years, 62.4% were female. Patient who underwent robotic cholecystectomy were more likely to be female (p=0.001), were more likely to be admitted during weekday (p<0.001), were treated at urban hospital (p<0.001), had an elective admission (p<0.001), and less likely to have acute cholecystitis (p<0.001) and more likely to have biliary colic (p<0.001). There was no difference in bile duct injury (p=0.43), in hospital mortality (p=0.26) or hospital length of stay (p=0.88) between two groups. Patients who underwent RaC had higher hospital charges compared to LaC (p<0.001).

Conclusion

Robotic cholecystectomy is not associated with an increase in bile duct injury rates. Relative to laparoscopic cholecystectomy, robotic cholecystectomy has greater hospital charges. Further studies are planned to address the incidence of complications and cost difference with growing robotic experience.

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