Robot-assisted and Fluorescence-guided Remnant-cholecystectomy: A Prospective Dual-Center Cohort Study

Anton F. Gijsen; Harry G.M. Vaassen; Alexander L. Vahrmeijer; Robert H. Geelkerken; Mike S.L. Liem; Maximilian Bockhorn; Nader El-Sourani; J. Sven D. Mieog; Daan J. Lips

doi:10.1016/j.hpb.2023.03.015

Robot-assisted and Fluorescence-guided Remnant-cholecystectomy: A Prospective Dual-Center Cohort Study

Anton F. Gijsen, Harry G.M. Vaassen, Alexander L. Vahrmeijer, Robert H. Geelkerken, Mike S.L. Liem, Maximilian Bockhorn, Nader El-Sourani, J. Sven D. Mieog, Daan J. Lips^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Background: Abdominal symptoms after cholecystectomy may be caused by gallstones in a remnant gallbladder or a long cystic duct stump. Resection of a remnant gallbladder or cystic duct stump is associated with an increased risk of conversion and bile duct or vascular injuries. We prospectively investigated the additional value of robotic assistance and fluorescent bile duct illumination in redo biliary surgery. Methods: In this prospective two-centre observational cohort study, 28 patients were included with an indication for redo biliary surgery because of remnant stones in a remnant gallbladder or long cystic duct stump. Surgery was performed with the da Vinci X® and Xi® robotic system. The biliary tract was visualised in the fluorescence Firefly® mode shortly after intravenous injection of indocyanine green. Results: There were no conversions or perioperative complications, especially no vascular or bile duct injuries. Fluorescence-based illumination of the extrahepatic bile ducts was successful in all cases. Symptoms were resolved in 27 of 28 patients. Ten patients were treated in day care and 13 patients were discharged the day after surgery. Conclusion: Robot-assisted fluorescence-guided surgery for remnant gallbladder or cystic duct stump resection is safe, effective and can be done in day-care setting.

Original language	English
Pages (from-to)	820-825
Number of pages	6
Journal	HPB
Volume	25
Issue number	7
Early online date	29 Mar 2023
DOIs	https://doi.org/10.1016/j.hpb.2023.03.015
Publication status	Published - Jul 2023

Keywords

2023 OA procedure

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10.1016/j.hpb.2023.03.015

1-s2.0-S1365182X23001016-mainFinal published version, 413 KBLicence: Taverne

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title = "Robot-assisted and Fluorescence-guided Remnant-cholecystectomy: A Prospective Dual-Center Cohort Study",

abstract = "Background: Abdominal symptoms after cholecystectomy may be caused by gallstones in a remnant gallbladder or a long cystic duct stump. Resection of a remnant gallbladder or cystic duct stump is associated with an increased risk of conversion and bile duct or vascular injuries. We prospectively investigated the additional value of robotic assistance and fluorescent bile duct illumination in redo biliary surgery. Methods: In this prospective two-centre observational cohort study, 28 patients were included with an indication for redo biliary surgery because of remnant stones in a remnant gallbladder or long cystic duct stump. Surgery was performed with the da Vinci X{\textregistered} and Xi{\textregistered} robotic system. The biliary tract was visualised in the fluorescence Firefly{\textregistered} mode shortly after intravenous injection of indocyanine green. Results: There were no conversions or perioperative complications, especially no vascular or bile duct injuries. Fluorescence-based illumination of the extrahepatic bile ducts was successful in all cases. Symptoms were resolved in 27 of 28 patients. Ten patients were treated in day care and 13 patients were discharged the day after surgery. Conclusion: Robot-assisted fluorescence-guided surgery for remnant gallbladder or cystic duct stump resection is safe, effective and can be done in day-care setting.",

keywords = "2023 OA procedure",

author = "Gijsen, {Anton F.} and Vaassen, {Harry G.M.} and Vahrmeijer, {Alexander L.} and Geelkerken, {Robert H.} and Liem, {Mike S.L.} and Maximilian Bockhorn and Nader El-Sourani and Mieog, {J. Sven D.} and Lips, {Daan J.}",

note = "Publisher Copyright: {\textcopyright} 2023 International Hepato-Pancreato-Biliary Association Inc.",

year = "2023",

month = jul,

doi = "10.1016/j.hpb.2023.03.015",

language = "English",

volume = "25",

pages = "820--825",

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number = "7",

}

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T1 - Robot-assisted and Fluorescence-guided Remnant-cholecystectomy: A Prospective Dual-Center Cohort Study

AU - Gijsen, Anton F.

AU - Vaassen, Harry G.M.

AU - Vahrmeijer, Alexander L.

AU - Geelkerken, Robert H.

AU - Liem, Mike S.L.

AU - Bockhorn, Maximilian

AU - El-Sourani, Nader

AU - Mieog, J. Sven D.

AU - Lips, Daan J.

PY - 2023/7

Y1 - 2023/7

N2 - Background: Abdominal symptoms after cholecystectomy may be caused by gallstones in a remnant gallbladder or a long cystic duct stump. Resection of a remnant gallbladder or cystic duct stump is associated with an increased risk of conversion and bile duct or vascular injuries. We prospectively investigated the additional value of robotic assistance and fluorescent bile duct illumination in redo biliary surgery. Methods: In this prospective two-centre observational cohort study, 28 patients were included with an indication for redo biliary surgery because of remnant stones in a remnant gallbladder or long cystic duct stump. Surgery was performed with the da Vinci X® and Xi® robotic system. The biliary tract was visualised in the fluorescence Firefly® mode shortly after intravenous injection of indocyanine green. Results: There were no conversions or perioperative complications, especially no vascular or bile duct injuries. Fluorescence-based illumination of the extrahepatic bile ducts was successful in all cases. Symptoms were resolved in 27 of 28 patients. Ten patients were treated in day care and 13 patients were discharged the day after surgery. Conclusion: Robot-assisted fluorescence-guided surgery for remnant gallbladder or cystic duct stump resection is safe, effective and can be done in day-care setting.

AB - Background: Abdominal symptoms after cholecystectomy may be caused by gallstones in a remnant gallbladder or a long cystic duct stump. Resection of a remnant gallbladder or cystic duct stump is associated with an increased risk of conversion and bile duct or vascular injuries. We prospectively investigated the additional value of robotic assistance and fluorescent bile duct illumination in redo biliary surgery. Methods: In this prospective two-centre observational cohort study, 28 patients were included with an indication for redo biliary surgery because of remnant stones in a remnant gallbladder or long cystic duct stump. Surgery was performed with the da Vinci X® and Xi® robotic system. The biliary tract was visualised in the fluorescence Firefly® mode shortly after intravenous injection of indocyanine green. Results: There were no conversions or perioperative complications, especially no vascular or bile duct injuries. Fluorescence-based illumination of the extrahepatic bile ducts was successful in all cases. Symptoms were resolved in 27 of 28 patients. Ten patients were treated in day care and 13 patients were discharged the day after surgery. Conclusion: Robot-assisted fluorescence-guided surgery for remnant gallbladder or cystic duct stump resection is safe, effective and can be done in day-care setting.

KW - 2023 OA procedure

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U2 - 10.1016/j.hpb.2023.03.015

DO - 10.1016/j.hpb.2023.03.015

M3 - Article

SN - 1365-182X

VL - 25

SP - 820

EP - 825

JO - HPB

JF - HPB

IS - 7

ER -

Robot-assisted and Fluorescence-guided Remnant-cholecystectomy: A Prospective Dual-Center Cohort Study

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