Da Vinci机器人辅助下肝门部胆管癌手术治疗术式选择与改进

Chinese Journal of Practical Surgery ›› 2010, Vol. 30 ›› Issue (01) : 44-46.

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Chinese Journal of Practical Surgery ›› 2010, Vol. 30 ›› Issue (01) : 44-46.
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da Vinci Robot-Assisted resection for hilar cholangiocarcinoma: preliminary experience from china ZHOU Ning-xin, LIU Quanda, CHEN Jun-zhou,et al. Institute of Hepatobiliary & Gastrointestinal Diseases, ERPAO General Hospital, Beijing 100088, China Corresponding author:ZHOU Ning-xin,E-mail:zhounx301@163.com Abstract Objective To summarize the initial experience of application of da Vinci Surgical System for resection of hilar cholangiocarcinoma.Methods Fifty-seven patients undergone robot-assisted hepatobiliopancreatic (HBP) operations from January to June 2009 were reviewed, and the clinical results of the 6 cases receiving resection of hilar cholangiocarcinoma were introduced.Results The Bismuth classification of 6 patients (5 male, 1 female, with average ages of 60±8 years old) with hilar cholangiocarcinoma was: 1 of type I, 2 of type IIIb, 3 of type Ⅳ. One patient performed PTC drainage 1-month ago. The robot-assisted surgical procedures included: radical resection of hilar cholangiocarcinoma and Roux-en-Y hepatojejunostomy for 1 patient with Bismuth type I, left hemihepatectomy for 1 patient with Bismuth type IIIb, resection of hilar cholangiocarcinoma and external drainage of secondary biliary radicals for 1 patient with Bismuth type IIIb, and resection of hilar cholangiocarcinoma and biliary reconstruction with gallbladder bridging for 3 patients with Bismuth type Ⅳ. All patients recovered uneventfully. Incomplete intestinal obstruction was occurred in one patient after overfeeding on fifth postoperative day, which was relieved by one-day fasting. No complications such as biliary leak, peritonitis occurred. No signs of tumor recurrence were revealed during a median 3-month follow-up period.Conclusion Robot-assisted resection for hilar cholangiocarcinoma is feasibility and safe. The robotic surgical system has superiority such as precision, dexterity while performing the operation, and faster recovery for patients, which offers the future trend for HBP minimally invasive surgery. However, further study is mandatory to clarify the longterm results following robot-assisted resection for hilar cholangiocarcinoma.

Key words

da Vinci surgical system / robotic surgery / hilar cholangiocarcinoma / minimally invasive surgery

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