HPB SO08 - Safety of Robotic cholecystectomy as index training procedure – the UK experience

Abstract Background A recent large retrospective cohort study reported a higher risk of bile duct injury associated with robotic cholecystectomy when compared to the laparoscopic approach. Considering that most robotic training pathways, including the one followed in the UK, utilise robotic cholecystectomy as index training procedure, such findings mandate evaluation of the safety profile of robotic cholecystectomy in the UK to ensure its use as an alternative approach to laparoscopic cholecystectomy is not putting patients at risk. We aimed to conduct a multi-centre observational study to evaluate the safety profile of robotic cholecystectomy performed within the UK HPB Robotic training program. Method A retrospective analysis of prospectively collected data from eleven centres participating in the UK robotic HPB training program was conducted. All adult patients undergoing robotic cholecystectomy for symptomatic gallstone disease or gallbladder polyp were considered. Bile duct injury, conversion to open procedure, conversion to subtotal cholecystectomy, length of hospital stay, 30-day re-admission, and post-operative complications were the evaluated outcome parameters. Results A total of 600 patients were included. The median age was 53 (IQR 65 - 41) years and the majority (72.7%; 436/600) were female. The main indications for robotic cholecystectomy were biliary colic (55.5%, 333/600), cholecystitis (18.8%, 113/600), gallbladder polyps (7.7%, 46/600) and pancreatitis (6.2%, 37/600). The median length of stay was 0 (IQR: 0-1) days. Of the included patients, 88.5% (531/600) were discharged on the day of procedure with 30-day re-admission rate of 5.5% (33/600). There were no bile duct injuries and the rate of conversion to open was 0.8% (5/600) with subtotal cholecystectomy rate of 0.8% (5/600). Conclusion This current study confirms that robotic cholecystectomy can be safely implemented to routine practice with a low risk of bile duct injury, low conversion to open surgery and low need for subtotal cholecystectomy.

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Journal
British journal of surgery
Published
2024-11-01
DOI
https://doi.org/10.1093/bjs/znae271.241
Primary Topic
Minimally Invasive Surgical Techniques
Type
article
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article

HPB SO08 - Safety of Robotic cholecystectomy as index training procedure – the UK experience

Ricky Bhogal, Zaed Hamady, Jason Ramsingh, Rafael Díaz-Nieto et al.
1 links
British journal of surgery
Minimally Invasive Surgical Techniques
article

HPB SO08 - Safety of Robotic cholecystectomy as index training procedure – the UK experience

Ricky Bhogal, Zaed Hamady, Jason Ramsingh, Rafael Díaz-Nieto, Ali Arshad, Shahin Hajibandeh, Edward Alabraba, Kai Tai Derek Yeung, Sailakshmi Krishnan, Vivek N. Upasani, Mohammad Alibrahim, Omar Alkhatib, Vikas Sud, Andrea Sheel, Vijayanand Dhakshinamoorthy, Jawad Ahmad, Ryan Baron, Declan Dunne, S. M. Picker, Imran Bhatti, Michael Silva, Daren Subar, Adam E. Frampton, Irena Stefanova, Zahir Soonawalla, Siong‐Seng Liau, Eleanor Kissane, Alexander Green, G. Papadopoulos, Vincent Wai‐Sun Wong, Altaf Awan, Rajesh Kumar, Angela Riga, Liam Horgan, Gabriele Marangoni, Shi Lam, Rajiv Lahiri, Tim Pencavel, Tim Worthington, Shyam Moudghalya
article en

Abstract

Abstract Background A recent large retrospective cohort study reported a higher risk of bile duct injury associated with robotic cholecystectomy when compared to the laparoscopic approach. Considering that most robotic training pathways, including the one followed in the UK, utilise robotic cholecystectomy as index training procedure, such findings mandate evaluation of the safety profile of robotic cholecystectomy in the UK to ensure its use as an alternative approach to laparoscopic cholecystectomy is not putting patients at risk. We aimed to conduct a multi-centre observational study to evaluate the safety profile of robotic cholecystectomy performed within the UK HPB Robotic training program. Method A retrospective analysis of prospectively collected data from eleven centres participating in the UK robotic HPB training program was conducted. All adult patients undergoing robotic cholecystectomy for symptomatic gallstone disease or gallbladder polyp were considered. Bile duct injury, conversion to open procedure, conversion to subtotal cholecystectomy, length of hospital stay, 30-day re-admission, and post-operative complications were the evaluated outcome parameters. Results A total of 600 patients were included. The median age was 53 (IQR 65 - 41) years and the majority (72.7%; 436/600) were female. The main indications for robotic cholecystectomy were biliary colic (55.5%, 333/600), cholecystitis (18.8%, 113/600), gallbladder polyps (7.7%, 46/600) and pancreatitis (6.2%, 37/600). The median length of stay was 0 (IQR: 0-1) days. Of the included patients, 88.5% (531/600) were discharged on the day of procedure with 30-day re-admission rate of 5.5% (33/600). There were no bile duct injuries and the rate of conversion to open was 0.8% (5/600) with subtotal cholecystectomy rate of 0.8% (5/600). Conclusion This current study confirms that robotic cholecystectomy can be safely implemented to routine practice with a low risk of bile duct injury, low conversion to open surgery and low need for subtotal cholecystectomy.

British journal of surgeryVol. 111(Supplement_9)
Royal Marsden NHS Foundation Trust (GB), University of Liverpool (GB), University of Hull (GB), Leeds Teaching Hospitals NHS Trust (GB), Royal Surrey County Hospital (GB), Liverpool Hospital (AU), Northumbria Healthcare NHS Foundation Trust (GB), Newcastle upon Tyne Hospitals NHS Foundation Trust (GB), Cambridge University Hospitals NHS Foundation Trust (GB), University Hospitals Coventry and Warwickshire NHS Trust (GB), Royal Liverpool University Hospital (GB), University Hospital Southampton NHS Foundation Trust (GB), Oxford University Hospitals NHS Trust (GB), University Hospitals of Derby and Burton NHS Foundation Trust (GB), East Lancashire Hospitals NHS Trust (GB)
Good health and well-being
Openalex Percentile: Top 62%
Minimally Invasive Surgical Techniques
DOISourceOpenAlex
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