Robot-assisted radical cholecystectomy for gallbladder cancer – A review

Abstract

Background: Radical cholecystectomy (RC) is recommended for Gallbladder cancer (GbC) patients with resectable T1b or higher stage. Traditionally, open RC is preferred over minimally invasive approach. Robotic surgery is increasingly gaining popularity and there are reports of robotic RC (RRC) for GbC. RRC is still new and mostly performed in high-volume centers with access to robotic technology. Aim: This study aims to review the current literature on the safety and feasibility of RRC for GbC. Methods: We performed a systematic review of RRC for GbC using PubMed and Embase until December 2020. The primary endpoint was major complications, while the secondary endpoints were conversion to open, R0 resection, and early recurrence. Results: Seven studies with 74 patients were included in the study. Overall, four patients (5.41%) required open conversion. Five out of 74 patients (6.76%) experienced post-operative complications. There was no post-operative mortality. Among the patients with surgical margins reported (n = 63), 61 patients had negative margins (96.8%) and only two patients had positive margins. Two-year survival outcomes were reported as 60.5-100%. Relevance for Patients: This is the first review that summarizes the current evidence on RRC for GbC. The endpoints suggest that RRC is feasible and safe in selected patients and when done in experienced centers. Understanding the strengths and limitations of RRC compared to other established therapeutic options may potentially aid surgeons in formulating the optimal treatment plan for GbC patients.