Robotic Type 3B Klatskin Tumor Resection: Technique of Unification Ductoplasty for Roux-en-Y Biliary Reconstruction.
Robotic Klatskin type 3B resection
Robotic cholangiocarcinoma resection
Robotic liver resection
Unification ductoplasty
Journal
Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
ISSN: 1873-4626
Titre abrégé: J Gastrointest Surg
Pays: Netherlands
ID NLM: 9706084
Informations de publication
Date de publication:
11 2023
11 2023
Historique:
received:
31
05
2023
accepted:
20
06
2023
medline:
22
11
2023
pubmed:
29
7
2023
entrez:
28
7
2023
Statut:
ppublish
Résumé
Application of robotic platform for perihilar cholangiocarcinoma is an emerging technique requiring expertise in both minimally invasive hepatic resection and biliary reconstruction. Due to oncological principles of trying to achieve tumor-free margins during cholangiocarcinoma operation, surgeons often find multiple sectoral bile ducts above the hilar plate that need to be reconstructed. Creating multiple oligomilimeter hepaticojejunostomy anastomoses is not only technically very challenging but also associated with an increased risk for postoperative bile leak and subsequent anastomotic stricture mandating reinterventions. Technical maneuvers to reduce the number of biliary anastomosis had been previously described in open surgical literature. Minimally invasive technique such as simple unification ductoplasty, however, has not been described laparoscopically or robotically. We demonstrated a successful unification ductoplasty during a robotic type 3B Klatskin tumor resection according to Bismuth-Corlette classification. Creation of multiple anastomoses in this type of operation was able to be avoided. Robotic platform facilitates ductoplasty for biliary reconstruction during Klatskin tumor resection.
Sections du résumé
BACKGROUND
Application of robotic platform for perihilar cholangiocarcinoma is an emerging technique requiring expertise in both minimally invasive hepatic resection and biliary reconstruction. Due to oncological principles of trying to achieve tumor-free margins during cholangiocarcinoma operation, surgeons often find multiple sectoral bile ducts above the hilar plate that need to be reconstructed. Creating multiple oligomilimeter hepaticojejunostomy anastomoses is not only technically very challenging but also associated with an increased risk for postoperative bile leak and subsequent anastomotic stricture mandating reinterventions.
METHODS
Technical maneuvers to reduce the number of biliary anastomosis had been previously described in open surgical literature. Minimally invasive technique such as simple unification ductoplasty, however, has not been described laparoscopically or robotically.
RESULTS
We demonstrated a successful unification ductoplasty during a robotic type 3B Klatskin tumor resection according to Bismuth-Corlette classification. Creation of multiple anastomoses in this type of operation was able to be avoided.
CONCLUSION
Robotic platform facilitates ductoplasty for biliary reconstruction during Klatskin tumor resection.
Identifiants
pubmed: 37507587
doi: 10.1007/s11605-023-05769-8
pii: S1091-255X(24)00043-X
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2662-2664Informations de copyright
© 2023. The Society for Surgery of the Alimentary Tract.
Références
Di Benedetto F, Magistri P, Catellani B, Guerrini GP, Di Sandro S. Robotic Left Hepatectomy with en bloc Caudatectomy and Multiple Biliary Anastomosis for Perihilar Cholangiocarcinoma. Ann Surg Oncol. 2023 30(5):2832-2833. https://doi.org/10.1245/s10434-022-13091-x .
doi: 10.1245/s10434-022-13091-x
pubmed: 36790730
Sucandy I, Ross S, Rosemurgy A. Robotic Resection of a Type IIIB Klatskin Tumor. J Gastrointest Surg. 2021 25(7):1939-1940. https://doi.org/10.1007/s11605-021-04968-5 .
doi: 10.1007/s11605-021-04968-5
pubmed: 33728593
Camerlo A, Seux H. ASO Author Reflections: Mini-Invasive Hilar Cholangiocarcinoma Resection: Could Robots Be the Key? Ann Surg Oncol. 2022 29(4):2408-2409. https://doi.org/10.1245/s10434-021-11219-z .
doi: 10.1245/s10434-021-11219-z
pubmed: 35006504