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Jacoby et al. Mini-invasive Surg 2022;6:58 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2022.58

Original Article Open Access

Robotic resection of hilar cholangiocarcinoma: a

single institution experience

Harel Jacoby, Shlomi Rayman, Sharona Ross, Kaitlyn Crespo, Cameron Syblis, Alexander Rosemurgy,
Iswanto Sucandy

Department of Surgery, Digestive Health Institute, Tampa, FL 33613, USA.
Correspondence to: Dr. Iswanto Sucandy, Division Chief of Hepatopancreatobiliary Surgery, Digestive Health Institute, 3000
Medical Park Drive, Suite 500, Tampa, FL 33613, USA. E-mail: iswanto.sucandy@adventhealth.com

How to cite this article: Jacoby H, Rayman S, Ross S, Crespo K, Syblis C, Rosemurgy A, Sucandy I. Robotic resection of hilar
cholangiocarcinoma: a single institution experience. Mini-invasive Surg 2022;6:58. https://dx.doi.org/10.20517/2574-
1225.2022.58

Received: 14 Jun 2022 First Decision: 8 Sep 2022 Revised: 26 Sep 2022 Accepted: 14 Nov 2022 Published: 21 Dec 2022

Academic Editors: Giulio Belli, David Geller Copy Editor: Ke-Cui Yang Production Editor: Ke-Cui Yang

Abstract
Aim: Hilar cholangiocarcinoma is an aggressive malignancy with a poor prognosis, for which only surgical resection
offers potential cure. Because of its complex location in the porta hepatis, the standard surgical approach has been
open surgery. With the gradual increase in the use of minimally invasive surgery, we aimed to describe our single
institutional experience of robotic resection of hilar cholangiocarcinoma. To the best of our knowledge, this is the
largest published series in North America.

Methods: Between 2016-2022, we prospectively followed all patients who underwent robotic extrahepatic biliary
resection for hilar cholangiocarcinoma.

Results: Robotic resection of hilar cholangiocarcinoma was performed on 21 patients of median age 72 years, 16
(76%) of whom underwent concomitant hepatectomy. All patients initially presented with jaundice and underwent
preoperative drainage. Median operative time was 458 minutes and the estimated blood loss was 150 mL. There
were no intraoperative complications or conversions to open surgery. The length of stay was five days, with one
readmission at 30 days. There were three postoperative complications and one postoperative mortality (at 90
days). R0 was attained in 90% (19/21) of cases and R1 in 10% (2/21). Our median follow-up time was 21 months.
At the final follow-up, 15 patients were alive with no evidence of disease and six died.

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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