Approach to manage the complications of choledochoduodenostomy: robot-assisted laparoscopic Roux-en-Y hepaticojejunostomy.

PURPOSE: To evaluate the technical feasibility and safety of robot-assisted laparoscopic Roux-en-Y hepaticojejunostomy, using the robotic surgical system.

METHODS: This is a report of the use of robot-assisted laparoscopic Roux-en-Y hepaticojejunostomy on 2 patients with recurrent pyogenic cholangitis. Both had past history of side-to-side choledochoduodenostomy with complications of Sump syndrome and benign biliary stricture, respectively.

RESULTS: Robot-assisted laparoscopic Roux-en-Y hepaticojejunostomy was completed successfully in these 2 patients. Both patients recovered from the operation, except for 1 patient who had minor bile leakage over the anastomosis 4 days after operation, which subsided after conservative treatment. The mean operating time was 300 minutes and 400 minutes, respectively. The blood loss was 20 mL and 10 mL, respectively. They were able to tolerate liquids on the second postoperative day. They were discharged 6 and 11 days after the operation, respectively.

CONCLUSIONS: Robot-assisted laparoscopic Roux-en-Y hepaticojejunostomy is a feasible and safe procedure. However, more large-scale studies with long-term follow-up results are needed.