title: Robot-assisted laparoscopic hepaticojejunostomy for advanced malignant biliary obstruction.
abstract: BACKGROUND
  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 tumor-related 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.
authors: Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong Special Administrative Region. Electronic address: ericlai@alumni.cuhk.edu.hk.
authors: Eric C H
authors: EC
authors: Lai
authors: Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong Special Administrative Region.
authors: Chung Ngai
authors: CN
authors: Tang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000713:Anastomosis, Roux-en-Y / Q000379:methods*; D001650:Bile Duct Neoplasms / Q000150:complications; D018281:Cholangiocarcinoma / Q000150:complications; D002779:Cholestasis / Q000209:etiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006500:Hepatic Duct, Common / Q000601:surgery*; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods; D010190:Pancreatic Neoplasms / Q000150:complications; D011183:Postoperative Complications / Q000453:epidemiology; D065287:Robotic Surgical Procedures / Q000379:methods*; D016896:Treatment Outcome
keywords: cholangiocarcinoma; hepaticojejunostomy; jaundice; pancreatic cancer; robot