Comparison of perioperative surgical outcomes following total robotic and total laparoscopic Roux-en Y hepaticojejunostomy for choledochal cyst in paediatric population: a preliminary report from a tertiary referral centre.

PURPOSE: There is a paucity of data regarding the comparison of robotic and laparoscopic hepaticojejunostomy (HJ) for the treatment of paediatric choledochal cysts. Thus, our primary objective was a comparison of early complications namely post-operative bleeding, anastomotic leak, intestinal obstruction and the need for reoperation in both techniques. Our secondary objectives included a comparison of the mean time for surgery and HJ, conversion of procedure to open, intraoperative blood loss, late complications like cholangitis, stricture and post-operative outcomes like time to start oral feeds and length of post-operative stay.

METHODS: A retrospective data analysis of all children who underwent laparoscopic and robotic choledochal cyst excision with Roux-en-Y HJ from 2008 to 2021 was performed.

RESULTS: Ninety patients were classified into Group R (robotic HJ), n = 20 and Group L (laparoscopic HJ), n = 70. Post-operative complications were comparable amongst groups R and L (2 vs 6; p = 1 and 1 vs 2, p = 0.53, respectively). Intraoperative blood loss was significantly less in group R (54.8 ± 13.5 ml vs 64.1 ± 17.3 ml; p = 0.0280). The mean time to complete HJ was significantly less in group R (58 ± 12 min vs 71 ± 11 min; p < 0.001) while the mean time to complete surgery was significantly more in Group R (284 ± 14 min vs 195 ± 18 min; p < 0.001).

CONCLUSION: Our preliminary research report suggests overall comparable early complications in both groups.