چکیده (انگلیسی):

Introduction: To report our experience in palliative hepaticojejunostomy for
advanced malignant biliary obstruction by means of robotic approach
Methods: Robot-assisted laparoscopic hepaticojejunostomy for advanced malignant biliary
obstruction was performed in nine patients from May 2009 to April 2014.
Results: During the study period, robotic hepaticojejunostomy for advanced malignant biliary
obstruction was completed successfully in nine patients. Roux-en-Y hepaticojejunostomy and
double (hepaticojejunostomy, and gastrojejunostomy) bypass were performed in five and four
patients, respectively. The mean operating time was 212.8 minutes. The mean blood loss was
38.7 mL. The overall complication rate was 22.2%. Bile leak complication occurred in one patient
only. There was no procedure-related mortality. The mean postoperative hospital stay
was 13.3 days. Five patients received palliative systemic chemotherapy after bypass surgery.
The mean survival time was 11.1 months. During follow up, only three patients with cholangiocarcinoma
had recurrent biliary obstruction after end-to-side hepaticojejunostomy due to tumor
progression, and needed percutaneous transhepatic biliary drainage. Among these nine
patients, there were a total of eight episodes of readmission in four patients due to tumorrelated
symptoms or complications.
Conclusions: Robot-assisted laparoscopic hepaticojejunostomy for advanced malignant biliary
obstruction had a low complication rate and was associated with an improved quality of life.