ArticleSurgical endoscopy2026
Robotic versus laparoscopic liver resection for intrahepatic cholangiocarcinoma in elderly patients: a multicentre propensity-weighted analysis.
Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
What it found
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Robotic versus laparoscopic surgery in older adults: a systematic review and meta-analysis of recovery-centered outcomes.Journal of robotic surgery · 2026Pooled it
- Learning curve of robotic pancreaticoduodenectomy: a CUSUM and risk-adjusted CUSUM analysis of 120 consecutive cases.Surgical endoscopy · 2026Article
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Authors and funding
36 authors.
Funding
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Abstract
backgroundEvidence comparing robotic and laparoscopic minimally invasive liver surgery (MILS) for intrahepatic cholangiocarcinoma (iCCA) in elderly patients remains limited. This study compared perioperative and oncological outcomes between the two approaches and identified factors associated with postoperative complications.
methodsA multicentre retrospective study was conducted across 13 high-volume hepatobiliary centres including consecutive patients aged ≥ 70 years undergoing MILS for iCCA. Propensity score-based inverse probability of treatment weighting (IPTW) was applied. Perioperative, pathological, and survival outcomes were analyzed.
resultsA total of 272 patients were included (194 laparoscopic, 78 robotic). After IPTW adjustment, robotic surgery showed a trend toward lower overall postoperative complication rates (16.2 vs 30.9%; p = 0.050), significantly lower rates of severe complications (6.6 vs 11.0%; p = 0.027), shorter hospital stay (6.5 vs 8.7 days; p < 0.001), and lower conversion rates (3.8 vs 15.4%; p < 0.001). At multivariable analysis, robotic surgery remained independently associated with reduced postoperative morbidity (OR 0.47, 95% CI 0.30-0.73; p < 0.001), whereas higher IWATE difficulty score and conversion to open surgery were independently associated with postoperative complications. The robotic approach was also associated with a higher lymph node yield after IPTW adjustment (8.3 ± 6.1 vs 5.4 ± 4.6; p = 0.005), while disease-free and overall survival were comparable between groups during the available follow-up. Although 90-day mortality was higher in the robotic group, only five deaths occurred overall.
conclusionsRobotic liver resection in elderly patients with iCCA was associated with improved short-term perioperative outcomes and lower conversion rates without evidence of inferior oncological outcomes. The higher 90-day mortality observed in the robotic group should be interpreted cautiously given the limited number of events. Operative complexity and conversion to open surgery were major determinants of postoperative morbidity.
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