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Hamad et al. Mini-invasive Surg 2023;7:16 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2023.03

Review Open Access

Laparoscopic and robotic approaches for treatment

of choledochal cysts in adults

2
1
Ahmad Hamad , Jaimie D. Nathan , Timothy M. Pawlik 1
1
Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research
Institute, Columbus, OH 43210, USA.
2
Department of Surgery, The Ohio State University College of Medicine, and Nationwide Children’s Hospital, Columbus, OH
43210, USA.
Correspondence to: Prof. Timothy Pawlik, Department of Surgery, The Ohio State University Wexner Medical Center and James
Cancer Hospital and Solove Research Institute, Columbus, OH 43210, USA. E-mail: tim.pawlik@osumc.edu
How to cite this article: Hamad A, Nathan JD, Pawlik TM. Laparoscopic and robotic approaches for treatment of choledochal
cysts in adults. Mini-invasive Surg 2023;7:16. https://dx.doi.org/10.20517/2574-1225.2023.03

Received: 14 Jan 2023 First Decision:7 Mar 2023 Revised: 27 Mar 2023 Accepted: 13 Apr 2023 Published: 4 May 2023
Academic Editor: Giulio Belli Copy Editor: Ke-Cui Yang Production Editor: Ke-Cui Yang

Abstract
Background: While well-described for hepatic and pancreatic resection, the minimally invasive (MIS) approach in
the treatment of choledochal cysts (CC) has been under-reported. Due to the technical complexity and steeper
learning curve of minimally invasive biliary reconstruction, the MIS approach has not been as widely adopted in
biliary surgery. We herein review the use of laparoscopic and robotic-assisted surgery in the treatment of CC.

Methods: A comprehensive review of the literature was performed on the use of laparoscopic and robotic-assisted
surgery in the treatment of CC.

Results: Similar morbidity and mortality rates were noted among patients undergoing laparoscopic choledochal
cyst resection (LCCR) compared with previous data from patients in the literature who had undergone an open
approach (OCCR, open choledochal cyst resection); however, LCCR was associated with longer operative times
and high conversion rates, largely attributable to the learning curve given the technically challenging nature of the
procedure. The robotic platform (RCCR, robotic choledochal cyst resection) has been shown to offer an advantage
in the hepaticojejunostomy anastomosis portion of CC resection vs. laparoscopy while providing comparable short-
term outcomes compared with the LCCR approach.

© The Author(s) 2023. 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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