Initial clinical outcomes of robotic resection for perihilar cholangiocarcinoma: Is it safe and effective?

Background and ObjectivesWe aimed to describe our outcomes of robotic resection for perihilar cholangiocarcinoma, the largest single institutional series in the Western hemisphere to date.MethodsBetween 2016 and 2022, we prospectively followed all patients who underwent robotic resection for perihilar cholangiocarcinoma.ResultsIn total, 23 patients underwent robotic resection for perihilar cholangiocarcinoma, 18 receiving concomitant hepatectomy. The median age was 73 years. Operative time was 470 min with an estimated blood loss of 150 mL. No intraoperative conversions to open or other intraoperative complications occurred. Median length of stay was 5 days. Four postoperative complications occurred. Three readmissions occurred within 30 days with one 90-day mortality. R0 resection was achieved in 87% of patients and R1 in 13% of patients. At a median follow-up of 27 months, 15 patients were alive without evidence of disease, two patients with local recurrence at 1 year, and six were deceased.ConclusionsUtilization of the robotic platform for perihilar cholangiocarcinoma is safe and feasible with excellent perioperative outcomes. Further studies are needed to determine the long-term oncological outcomes. Robotic resection of perihilar cholangiocarcinoma is safe and effective when performed by experienced minimally invasive hepatobiliary surgeons in a population of carefully chosen patients. This institution series of robotically assisted resection of perihilar cholangiocarcinoma from a high-volume minimally invasive hepatobiliary program demonstrates excellent perioperative outcomes while achieving a shorter length of stay than what has been previously reported in the literature.