Robotic versus laparoscopic cholecystectomy for difficult gallbladders: an observational study of tertiary centre cases

• DOI: 10.1007/s00464-025-11586-8
• Publication Date: 2025-03-21T20:19:07Z
• Authors: Michal Kawka; Zaynab A. R. Jawad; David Hakim; Madhava Pai; Scarlet Nazarian; Tamara M. H. Gall; Christopher Wadsw...; David Nicol; Long R. Jiao
• Keywords: Open cholecystectomy; Tertiary referral hospital

Abstract Background Although laparoscopic cholecystectomy (LC) is considered a low-risk procedure, intraoperative bleeding, bile duct injury and leak occur frequently in the ‘difficult’ gallbladder. Robotic (RC) can overcome difficulties related to poor vision instrumentation difficult cases avoid complications conversion open surgery. The aim of study was evaluate outcomes robotic patients with gallbladders referred tertiary HPB centre. Methods We conducted retrospective review all senior hepatobiliary pancreatic surgeon gallbladder between December 2013 March 2024. Primary were 30-day post-operative complications. Results A total 88 ( n = 35 laparoscopic, 53 robotic) centre during period, consisting 21.7% cholecystectomies 404). complication rate (14.3% vs 3.8%, OR 4.25, 95% CI 0.77–23.28, p 0.0951) (8.6% 0.0%, 11.52, 0.57–230.32, 0.109) both higher group, but these differences not statistically significant. median operative time significantly group (108.5 min 50.0 min, 0.001). Conclusions Both are viable approaches cases, being associated potentially fewer conversions Pre-operative referral intra-operative abandonment be safe exit strategies for cases.