| Title |
Robot-assisted hepatectomy and complete excision of the extrahepatic bile duct for type IV-A choledochal cysts
|
|---|---|
| Published in |
Surgical Endoscopy, April 2016
|
| DOI | 10.1007/s00464-016-4923-9 |
| Pubmed ID | |
| Authors |
Ji Wool Ko, Sung Hoon Choi, Sung Won Kwon, Kwang Hyun Ko |
| Abstract |
Complete removal of the dilated biliary tree is regarded as inevitable in choledochal cysts due to its malignant potential. However, technical difficulty and the high risk of postoperative complications as well as the various presentations of the disease make the surgical options for type IV-A cysts challenging and controversial. We report the first case of a type IV-A choledochal cyst treated using a robot-assisted approach. A 41-year-old healthy female was admitted with intrahepatic and extrahepatic cysts incidentally found on routine checkup. Preoperative image studies showed two large cystic dilatations of the main biliary tract at the hilum and distal common bile duct as well as multiple cystic dilatations of the left intrahepatic duct. Anomalous pancreatico-biliary duct union was also found. The mid common bile duct was transected first, and the distal cystic bile duct of the intrapancreatic portion was resected at the junction with the pancreatic duct. The hilar cyst involved the right intrahepatic portion; therefore, liver resection proceeded to the right lobe, removing the caudate lobe. The right anterior and posterior hepatic ducts were securely isolated and resected with the help of real-time fluorescent imaging using an ICG. Roux-en-Y hepaticojejunostomy was performed intracorporeally. The total operation time was 540 min. The estimated amount of intraoperative bleeding was 750 ml. No blood transfusion was given. CT on postoperative day 6 showed no complications. Pathologic examination was accorded in choledochal cysts without evidence of malignancy. The patient was discharged on postoperative day 7 in good condition. Hepatectomy and complete excision of the extrahepatic bile duct for type IV-A choledochal cysts requires fine and delicate surgical techniques. The wrist-like movement of the working instruments and the firefly imaging of the robot surgical system allowed this advanced minimally invasive surgery to be successfully performed on this patient. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 34 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 34 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 6 | 18% |
| Student > Bachelor | 5 | 15% |
| Student > Ph. D. Student | 3 | 9% |
| Other | 2 | 6% |
| Student > Doctoral Student | 2 | 6% |
| Other | 3 | 9% |
| Unknown | 13 | 38% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 14 | 41% |
| Nursing and Health Professions | 2 | 6% |
| Agricultural and Biological Sciences | 1 | 3% |
| Unknown | 17 | 50% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 May 2016.
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#20,323,943
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#5,659
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#253,361
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Outputs of similar age from Surgical Endoscopy
#112
of 129 outputs
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