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Page 6 of 10 Lee et al. Mini-invasive Surg 2021;5:57 https://dx.doi.org/10.20517/2574-1225.2021.139

Table 3. Perioperative outcomes of published case series in which more than 5 patients with gallbladder cancer underwent
laparoscopic extended cholecystectomy
Number of Open conversion Operative Blood Complication, n Hospital
Publication Indication
GBC patients (reason) time, min loss, mL (%) stay, days
[5]
Cho et al. 18 Primary 1 (portal vein injury) 190* 50* 3 (16.7) 4*
de Aretxabala et al. [12] 7 Completion 2 (LN metastasis, NA NA 0 3
bile duct injury)
[13]
Gumbs et al. 15 Primary (10), 1 (CBD resection) 220 160 0 4
completion (5)
[14]
Agarwal et al. 24 Primary (20), 0 270* 200* 3 (12.5) 5*
completion (4)
[15]
Itano et al. 16 Primary (16) 0 360 152 1 (5.2) 9
Shirobe et al. [16] 11 Primary (4), 1 (CBD resection) 196 92 1 (9.1) 6
completion (7)
Yoon et al. [8] 30 Primary 1 (portal vein injury) 205* 100* 6 (18.8) 4*
[17]
Palanisamy et al. 1 Primary 0 213 196 4 (28.6) 5
*Median. LN: Lymph node; GBC: gallbladder cancer.

Table 4. Oncologic outcomes of published case series that included more than 5 patients with gallbladder cancer who underwent
laparoscopic extended cholecystectomy

Publication 7th AJCC stage Curative No. of retrieved Recurrence Survival
resection, % LNs (local/systemic)
Cho et al. [5] I (6), II (8), IIIB (2) 100 8* 0 NA
[12]
de Aretxabala et al. NA NA 6 1 (systemic) NA
Gumbs et al. [13] I (4), II (8), IIIB (3) 100 4 2 (local, systemic) NA
[14]
Agarwal et al. I (3), II (10), IIIA (6), 100 10* 1 (local) NA
IIIB (5)
[15]
Itano et al. I (3), II (13) 100 13 0 NA
Shirobe et al. [16] I (3), II (6), IIIB (2) 82 13 2 (local + systemic, local) 5-year survival rate:
100% for T1b
83.3% for T2
[8]
Yoon et al. I (8), II (17), IIIB (5) 100 7* 4 (systemic) 5-year survival rate:
94.2%
Palanisamy et al. [17] II (8), IIIA (1), IIIB (3) 100 8* 2 (systemic) 5-year survival rate;
68.75%
*Median. AJCC: American Joint Committee for Cancer; LN: lymph node; NA: not applicable.

pancreatectomy and hepatectomy.

When performing robotic pancreaticoduodenectomy, there is a definite benefit in facilitating anastomosis
with higher degree of freedom. When pancreaticojejunostomy is performed by laparoscopy, there is limited
freedom of instrument motion, and the needle holder manipulation is difficult. In contrast, when
pancreaticojejunostomy is performed by the robot-assisted method, suturing can be performed almost the
same as in open surgery, without any limitation of movement.

There have been several early reports of robotic surgery for GBC [3,18,19] . In 2020, Belli et al. reported their
[20]
experience on robotic surgery for 8 patients with GBC, with a mean operative time of 147 minutes and a 0%
conversion rate. However, some issues need to be addressed. Surgery of GBC ranges from relatively simple
cholecystectomy and lymphadenectomy to liver resection and bile duct resection. Early GBC may only
require cholecystectomy with or without lymphadenectomy. Advanced cases may require extensive surgery
with liver resection, and/or bile duct resection. If the operation is complicated, either laparoscopy and