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Changes in outcomes and operative trends with pediatric robot-assisted resection of choledochal cyst

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Abstract

Background

This study aimed to report our experience with a robot-assisted resection of choledochal cysts (CCs) in pediatric patients, especially focusing on changes in outcomes and operative trends.

Methods

We retrospectively reviewed medical records of all 158 patients under 18 years of age who underwent robot-assisted resection of CC in a single tertiary center between July 2008 and January 2021. Patients were divided into the first period (P1, July 2008–March 2016; N = 79) and second period (P2, April 2016–January 2021; N = 79) with equal number of participants. The patients of P2 were compared with those of P1 to assess clinical outcomes with operative details. Operative characteristics and postoperative prognosis were compared for each group.

Results

The mean operative time was 383.6 min for the P2 group and 462.6 min for the P1 group (p < 0.001). The mean estimated blood loss was 28 mL in the P2 group and 63 mL in the P1 group (p = 0.025). The rate of emergency department visit after the operation was lower in the P2 group (3.8% vs. 13.9%, respectively, p = 0.047). The two groups showed no significant differences in the rate of late postoperative complications and reoperations.

Conclusion

With the increase in the center’s experience, robot-assisted resection of CC can be safely adopted and feasible, especially for pediatric patients.

Levels of evidence

Treatment Study, Level III.

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References

  1. Lipsett PA, Pitt HA (2003) Surgical treatment of choledochal cysts. J Hepatobiliary Pancreat Surg 10(5):352–359

    Article  Google Scholar 

  2. Miyano T, Yamataka A (1997) Choledochal cysts. Curr Opin Pediatr 9(3):283–288

    Article  CAS  Google Scholar 

  3. Zhang B, Wu D, Fang Y, Bai J, Huang W, Liu M, Chen J, Li L (2019) Early complications after laparoscopic resection of choledochal cyst. Pediatr Surg Int 35(8):845–852

    Article  Google Scholar 

  4. Tang ST, Yang Y, Wang Y, Mao YZ, Li SW, Tong QS, Cao GQ, Zhao ZX (2011) Laparoscopic choledochal cyst excision, hepaticojejunostomy, and extracorporeal Roux-en-Y anastomosis: a technical skill and intermediate-term report in 62 cases. Surg Endosc 25(2):416–422

    Article  Google Scholar 

  5. Chokshi NK, Guner YS, Aranda A, Shin CE, Ford HR, Nguyen NX (2009) Laparoscopic choledochal cyst excision: lessons learned in our experience. J Laparoendosc Adv Surg Tech A 19(1):87–91

    Article  Google Scholar 

  6. Meehan JJ (2009) Robotic surgery in small children: is there room for this? J Laparoendosc Adv Surg Tech A 19(5):707–712

    Article  Google Scholar 

  7. Meehan JJ, Sandler A (2008) Pediatric robotic surgery: a single-institutional review of the first 100 consecutive cases. Surg Endosc 22(1):177–182

    Article  Google Scholar 

  8. Xie X, Li K, Wang J, Wang C, Xiang B (2020) Comparison of pediatric choledochal cyst excisions with open procedures, laparoscopic procedures and robot-assisted procedures: a retrospective study. Surg Endosc 34(7):3223–3231

    Article  Google Scholar 

  9. Pham HD, Okata Y, Vu HM, Tran NX, Nguyen QT, Nguyen LT (2019) Robotic-assisted surgery for choledochal cyst in children: early experience at Vietnam national children’s hospital. Pediatr Surg Int 35(11):1211–1216

    Article  Google Scholar 

  10. Koga H, Murakami H, Ochi T, Miyano G, Lane GJ, Yamataka A (2019) Comparison of robotic versus laparoscopic hepaticojejunostomy for choledochal cyst in children: a first report. Pediatr Surg Int 35(12):1421–1425

    Article  Google Scholar 

  11. Chang EY, Hong YJ, Chang HK, Oh JT, Han SJ (2012) Lessons and tips from the experience of pediatric robotic choledochal cyst resection. J Laparoendosc Adv Surg Tech A 22(6):609–614

    Article  Google Scholar 

  12. Kim NY, Chang EY, Hong YJ, Park S, Kim HY, Bai SJ, Han SJ (2015) Retrospective assessment of the validity of robotic surgery in comparison to open surgery for pediatric choledochal cyst. Yonsei Med J 56(3):737–743

    Article  Google Scholar 

  13. Dawrant MJ, Najmaldin AS, Alizai NK (2010) Robot-assisted resection of choledochal cysts and hepaticojejunostomy in children less than 10 kg. J Pediatr Surg 45(12):2364–2368

    Article  Google Scholar 

  14. Xie X, Li Y, Li K, Wang Q, Xiang B (2021) Total robot-assisted choledochal cyst excision using da Vinci surgical system in pediatrics: report of 10 cases. J Pediatr Surg 56(3):553–558

    Article  Google Scholar 

  15. Singham J, Yoshida EM, Scudamore CH (2010) Choledochal cysts. Part 3 of 3: management. Can J Surg 53(1):51–56

    PubMed  PubMed Central  Google Scholar 

  16. Xia HT, Yang T, Liang B, Zeng JP, Dong JH (2016) Treatment and outcomes of adults with remnant intrapancreatic choledochal cysts. Surgery 159(2):418–425

    Article  Google Scholar 

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Acknowledgements

The authors thank Medical Illustration & Design, part of the Medical Research Support Services of Yonsei University College of Medicine, for all artistic support related to this work.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Pediatric Surgery, Department of Surgery, Severance Children’s Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea

    Kyong Ihn, In Geol Ho, Ho Jong Jeon, Dongeun Lee & Seok Joo Han

  2. Department of Surgery, Yong-in Severance Hospital, Yonsei University College of Medicine, 363 Dongbaekjukjeon-daero, Giheung-gu, Yongin-si, Gyeonggi-do, 16995, Republic of Korea

    Young Ju Hong

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  1. Kyong Ihn
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  2. In Geol Ho
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Correspondence to Seok Joo Han.

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Kyong Ihn, In Geol Ho, Young Ju Hong, Ho Jong Jeon, Dongeun Lee and Seok Joo Han have no have no relevant financial conflicts of interest to disclose.

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Ihn, K., Ho, I.G., Hong, Y.J. et al. Changes in outcomes and operative trends with pediatric robot-assisted resection of choledochal cyst. Surg Endosc 36, 2697–2704 (2022). https://doi.org/10.1007/s00464-021-08844-w

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  • DOI: https://doi.org/10.1007/s00464-021-08844-w

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