Meta-analysis of short-term and long-term outcomes of robot-assisted and open radical surgery for hilar cholangiocarcinoma

Abstract

   Aim. To review the comparative studies into robot-assisted and open surgeries for hilar cholangiocarcinoma.   Materials and methods. Search for the comparative studies into the results of robot-assisted and open surgeries in patients with hilar cholangiocarcinoma was performed using electronic databases Embase, MEDLINE, Web of Science and Google Scholar by keywords “robotic” AND “hilar cholangiocarcinoma” OR “perihilar cholangiocarcinoma” OR “Klatskin tumor” published by December 31, 2023.   Results. The meta-analysis involves the results of 169 resections, including 53 robot-assisted and 116 open surgeries. Robot-assisted interventions revealed longer surgery duration (weighted mean difference (WMD) = 157.49, CI = 95 % [102.85; 212.12], р < 0.00001), less amount of intraoperative blood loss, close to statistically significant (WMD = −76.41, CI = 95 % [−159.90; 7.08], р = 0.07). Robot-assisted and open surgery groups appear comparable in terms of their perioperative parameters, including blood transfusion rate, number of R0 resections, number of lymph nodes removed, rate of postoperative complications, length of hospital stay, in-hospital mortality, as well as overall and event-free survival rates.   Conclusion. Meta-analysis of short-term and long-term outcomes of robot-assisted and open surgeries for hilar cholangiocarcinoma of the liver and bile ducts proves the potential and possibility for using robotic technologies in selective patients.