Robot-assisted liver resections in locally advanced intrahepatic cholangiocarcinoma

M. G. Efanov, N. Britskaia, P. V. Tarakanov, A. Koroleva, A. Vankovich, D. Kovalenko, V. Tsvirkun
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Abstract

Aim. To evaluate the immediate results of robot-assisted liver resections in locally advanced intrahepatic cholangiocarcinoma.Materials and methods. The research methodology involved the analysis of intraoperative and direct results of robotassisted liver resections from 2015 to June 2023.Results. Total of 89 patients with intrahepatic cholangiocarcinoma underwent surgery. Open liver resection was performed in 59 cases (66.3%), laparoscopic resection – in 22 cases (24.7%), robot-assisted resection – in 8 cases (8.9%). The share of massive liver resections accounted for 83%. The average duration of robot-assisted liver resection amounted to 545 (327–640) minutes, blood loss volume – 300 (100–750) ml, number of resected lymph nodes – 7 (5–11), resection margin width – 6 (5–14) mm. All patients underwent extensive resection with elements of vascular or biliary resection. Severe complications developed only in half of the patients. No deaths or liver failures were reported. The average duration of hospital stay after surgery amounted to 11 (6–15) days.Conclusion. Robot-assisted liver resections expand the indications for minimally invasive surgeries in intrahepatic cholangiocarcinoma due to patients with locally advanced forms. Satisfactory immediate results justify further accumulation and evaluation of the experience of such interventions.
局部晚期肝内胆管癌的机器人辅助肝脏切除术
目的评估局部晚期肝内胆管癌机器人辅助肝切除术的直接效果。研究方法包括分析2015年至2023年6月期间机器人辅助肝切除术的术中和直接效果。共有89例肝内胆管癌患者接受了手术。59例(66.3%)进行了开腹肝切除术,22例(24.7%)进行了腹腔镜切除术,8例(8.9%)进行了机器人辅助切除术。大块肝切除术占 83%。机器人辅助肝脏切除术的平均时间为545(327-640)分钟,失血量为300(100-750)毫升,切除淋巴结数量为7(5-11)个,切除边缘宽度为6(5-14)毫米。所有患者都接受了广泛切除术,包括血管或胆道切除术。只有半数患者出现严重并发症。没有死亡或肝功能衰竭的报告。术后平均住院时间为11(6-15)天。机器人辅助肝脏切除术扩大了局部晚期肝内胆管癌微创手术的适应症。令人满意的即时效果证明,有必要进一步积累和评估此类干预的经验。
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