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Laparoscopic and robot-assisted surgery for adult congenital biliary dilatation achieves favorable short-term outcomes without increasing the risk of late complications

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Abstract

Purpose

Minimally invasive surgery (MIS) is the optimal treatment for congenital biliary dilatation (CBD), but few studies on adults have been reported. We compared the postoperative outcomes of MIS with those of open surgery (OS) in adult patients with CBD.

Methods

The subjects of this retrospective study were 36 adult patients who underwent surgery for CBD. We compared the postoperative outcomes of 20 patients who underwent laparoscopic (n = 15) or robotic (n = 5) surgery with those of 16 patients who underwent OS.

Results

MIS was associated with a significantly higher rate of type I (p < 0.001), significantly less blood loss (p < 0.001), a significantly lower rate of internal stents (p = 0.048), significantly longer operation times (p = 0.009), and a significantly shorter postoperative hospital stay (p = 0.007) than OS. The postoperative outcomes of MIS for type I CBD were similar to those of the whole cohort. There were no significant differences in late complications between the groups. The robotic procedure had a significantly shorter operative time than laparoscopic surgery for hepaticojejunostomy (HJ; p = 0.029).

Conclusions

MIS achieved favorable short-term outcomes without compromising mid-term outcomes compared to OS and is appropriate for adult patients with CBD. Robotic HJ may be more ideal than its laparoscopic counterpart.

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Acknowledgements

T.M., T.T., M.I., and T. Miura were involved in the conception and design of the study, as well as the acquisition, analysis, and interpretation of data, drafting of the manuscript, and its final approval. H.O., M.M., and K.N. were involved in the acquisition of data, critical revision, and final approval. T. K, T.N., and M.U. were involved in critical revision and final approval.

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Authors and Affiliations

  1. Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan

    Takanori Morikawa, Hideo Ohtsuka, Tatsuyuki Takadate, Masaharu Ishida, Takayuki Miura, Masamichi Mizuma, Kei Nakagawa, Takashi Kamei & Michiaki Unno

  2. Department of Surgery, National Hospital Organization Sendai Medical Center, Sendai, Japan

    Tatsuyuki Takadate

  3. Department of Lower Gastrointestinal Surgery, Kitasato University School of Medicine, Sagamihara, Japan

    Takeshi Naitoh

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  1. Takanori Morikawa
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Correspondence to Takanori Morikawa.

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Morikawa, T., Ohtsuka, H., Takadate, T. et al. Laparoscopic and robot-assisted surgery for adult congenital biliary dilatation achieves favorable short-term outcomes without increasing the risk of late complications. Surg Today 52, 1039–1047 (2022). https://doi.org/10.1007/s00595-021-02438-8

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