Background

A variety of techniques have been described for the construction of the HJ (hepaticojejunostomy). Due to its technical challenges, HJ is rarely performed in a pure laparoscopic setting. In stark contrast, the increasing availability of the robotic platform has sparked new interest in pursuing this procedure in a minimally invasive fashion. The aim of our study was to describe our surgical technique and to identify risk factors for anastomotic leak and stenosis following robotic surgery.

Methods

We performed a retrospective analysis of a prospectively collected database, including all consecutive HJ carried out for different indications over a 10 year period.

Results

One hundred fifty-two patients undergoing robotic HJ performed by the same surgeon were analyzed. Bile leak occurred in 2.6% of the patients. Stricture rate was 3.3%. The median follow up was 25.5 months. There was no mortality related to anastomotic complications. On univariate analysis, patient's age less than 65 years was the only risk factor for anastomotic stricture. On multivariate analysis, no predictor factors for leak or stenosis were identified.

Conclusion

HJs carried out in a robotic fashion allow highly satisfactory results. No independent risk factors for bile leak of stenosis were identified on multivariate analysis.

中文翻译：

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机器人肝空肠吻合术：吻合口漏和狭窄的手术技术和危险因素分析

背景

已经描述了用于构建 HJ（肝空肠吻合术）的各种技术。由于其技术挑战，HJ 很少在纯腹腔镜设置中进行。与此形成鲜明对比的是，机器人平台的日益普及激发了以微创方式进行该手术的新兴趣。我们研究的目的是描述我们的手术技术并确定机器人手术后吻合口瘘和狭窄的危险因素。

方法

我们对前瞻性收集的数据库进行了回顾性分析，包括在 10 年内针对不同适应症进行的所有连续 HJ。

结果

对 152 名接受由同一外科医生执行的机器人 HJ 的患者进行了分析。2.6% 的患者发生胆漏。狭窄率为 3.3%。中位随访时间为 25.5 个月。没有与吻合口并发症相关的死亡。在单变量分析中，患者年龄小于 65 岁是吻合口狭窄的唯一危险因素。在多变量分析中，没有发现泄漏或狭窄的预测因素。

结论

以机器人方式进行的 HJ 可以获得非常令人满意的结果。在多变量分析中没有发现狭窄胆漏的独立危险因素。