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Robotic Resection of Hilar Cholangiocarcinoma

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Hilar cholangiocarcinoma is the most common malignant neoplasm of the biliary tract. Surgical resection is the only curative modality of treatment. The aim of this video is to present a robotic left hepatectomy extended to caudate lobe, combined with bile duct resection, lymphadenectomy, and Roux-en-Y biliary reconstruction.

Methods

A 76-year-old female presented with progressive jaundice due to hilar cholangiocarcinoma. She underwent chemoradiation and after 5 months of treatment was referred for second opinion; imaging reevaluation showed objective response and no arterial invasion. Multidisciplinary team decided for radical treatment, which consisted in robotic left hepatectomy, caudate lobe resection, resection of bile duct, lymphadenectomy, and hepaticojejunostomy.

Results

Operative time was 8 h. Estimated blood loss was 740 mL (received 2 U). The patient’s recovery was complicated by drainage clogging resulting in fever and perihepatic fluid collection, successfully treated by change of drainage. Pathology confirmed cholangiocarcinoma with free surgical margins (T1aN0). The patient is well, with no signs of disease 5 months after the procedure.

Conclusions

Robotic resection of hilar cholangiocarcinoma is feasible and safe. The robotic approach has some technical advantages over laparoscopic approach. This video may help oncological surgeons to perform this complex procedure.

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Disclosures

The authors declare no conflicts of interest.

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Authors and Affiliations

  1. Department of Surgery, University of São Paulo, São Paulo, Brazil

    Marcel Autran Machado MD, FACS

  2. Nove de Julho Hospital, São Paulo, Brazil

    Marcel Autran Machado MD, FACS, Bruno V. Mattos MD, Murillo Macedo Lobo Filho MD & Fabio Makdissi MD

Authors
  1. Marcel Autran Machado MD, FACS
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  2. Bruno V. Mattos MD
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  3. Murillo Macedo Lobo Filho MD
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  4. Fabio Makdissi MD
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Corresponding author

Correspondence to Marcel Autran Machado MD, FACS.

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Machado, M.A., Mattos, B.V., Lobo Filho, M.M. et al. Robotic Resection of Hilar Cholangiocarcinoma. Ann Surg Oncol 27, 4166–4170 (2020). https://doi.org/10.1245/s10434-020-08514-6

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  • DOI: https://doi.org/10.1245/s10434-020-08514-6

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