Robotic-assisted radical resection for perihilar cholangiocarcinoma (CCA) may allow for a higher number of total lymph nodes examined (TLNE) during surgery compared to open surgery, according to a study published in Gastroenterology Report.

The median TLNE during robotic-assisted radical resection surgery was significantly higher (n=11) compared to the TLNE during open surgery (n=5) for perihilar CCA (P =.010). The operation time during robotic-assisted resection was significantly longer than open surgery, however (548 min vs 353 min; P =.004).

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The robotic-assisted group also tended to have less intraoperative blood loss (125 mL vs 350 mL) and required fewer blood transfusions (30% vs 70% of patients), although the differences were not significant (P =.067 and P =.056, respectively). Overall postoperative morbidities also tended to be lower in the robotic-assisted group than the open surgery group (30% vs 70%), but the results were again not significant (P =.056).

“Although robotic-assisted surgery had a longer operation time, it tended to have lower intraoperative blood loss, blood transfusion rates, and post-operative morbidities than open surgery. It represents 1 feasible and safe technique for selected [perihilar CCA] patients. Its effectiveness in the short-term and long-term outcomes of [perihilar CCA] needs to be further explored,” the authors wrote.

No significant differences were observed in the negative resection margins (P =.640), postoperative major morbidities (P =.235), or postoperative length-of-stay (P =.155) between the 2 groups.

A total of 86 patients with perihilar CCA who underwent radical resection surgery between July 2017 and July 2022 at a single clinical site in China were enrolled in the study. After propensity-score matching, a total of 10 patients who received robotic-assisted resection and 20 patients who received open surgery were included in the study.

No significant differences were observed between the 2 groups in terms of age, sex, BMI, American Society of Anesthesiologists (ASA) classification, comorbidities (diabetes and hypertension), tumor size, Bismuth–Corlette classifications, preoperative biliary drainage, and tumor stage.


Huang XT, Xie JZ, Cai JP, et al. Evaluation of the short-term outcomes of robotic-assisted radical resection for perihilar cholangiocarcinoma: a propensity-scored matching analysis. Gastroenterol Rep. Published online April 10, 2023. doi:10.1093/gastro/goad018