Comparison of short- and long-term outcomes between robotic and laparoscopic operation in hilar cholangiocarcinoma patients: a case control study.

Background: Robotic surgery (RS) has gained increasing acceptance due to its ability to overcome certain limitations associated with laparoscopic surgery (LS). However, the performance of RS in hilar cholangiocarcinoma (HCCA) patients compared with LS remain unclear. This study aimed to compare the short- and long-term outcomes of RS versus LS in patients with HCCA.

Method: This retrospective study included patients who underwent radical resection of HCCA between February 2020 and August 2024. Baseline characteristics, pathological findings, surgical outcomes, and long-term outcomes were analyzed and compared between the RS and LS group.

Results: The baseline characteristics and pathologic findings of both groups were comparable. The RS group had less estimated blood loss [300 (175-400) vs 700 (200-750) ml, p = 0.008], and lower ALT, AST, TBIL, and DBIL compared to LS group, while no significant differences in postoperative complications. Regarding long-term outcomes, the overall survival rates and recurrence-free survival rates were comparable in two groups (p = 0.77 and p = 0.17, respectively).

Conclusion: This study demonstrated that robotic surgery for HCCA generally achieves satisfactory perioperative outcomes compared to laparoscopic surgery. With continued advancements in surgical techniques and accumulation of experience, robotic radical resection for HCCA could become a routine approach in the future.