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Oral Presentation - 85
Comparation of robot‑assisted and laparoscopy‑assisted biliary dilatation resection in children less than 3 months of age: a single‑center cohort study
Zhigang Gao, Qingjiang Chen, Yi Jin, Shuhao Zhang, Qiang Shu
Children's Hospital, Zhejiang University School of Medicine
Objective To investigate the feasibility and effectiveness of robot‑assisted surgery in children with cholangiectasis under 3 months of age. Methods Retrospective cohort study the clinical data of 53 children with cholangiectasis under 3 months admitted to our hospital from April 2019 to December 2024 were included retrospectively. According to the surgical method, the patients were divided into robotic‑assisted surgery(RAS) group(5 males, 24 females, age 49.0(36.0)days(range:19.0to90.0days), weight 5.00(1.65)kg(range:3.40to7.50kg) and laparoscopic‑assisted surgery(LAS) group (5 males, 19 females, age 55.5(27.3) days (range: 18.0to87.0days), weight 4.90(1.62)kg(range: 3.50to6.20kg). Nineteen cases in each group were prenatally diagnosed. Data were statistically analyzed using the Mann‑Whitney U test and the Pearson χ2 test, respectively. Results No statistically significant differences were observed between two groups in age, sex, weight, or preoperative biochemical indices(all P>0.05). All procedures were successfully completed without conversion to open surgery. Postoperative biochemical indices, fasting duration, cyst diameter, operative time, drainage tube retention time, and follow‑up duration showed no significant differences between the groups(all P>0.05). Compared to the LAS group, the RAS group demonstrated significantly shorter postoperative hospital stays (9.0(5.0)days(range:7.0to18.0days) vs. 11.5(5.5)days (range:7.0to38.0days), P=0.044) and hepaticojejunostomy time(15.0(3.5)minutes(range: 11.0to22.0minutes) vs. 18.0(3.0)minutes (range: 13.0to25.0minutes),P=0.001). However, the RAS group incurred higher surgical costs (78099.9(10100.1)yuan(range: 72148.7to112 898.6 yuan) vs. 30158.6(15283.1)yuan (range: 25041.7to107673.1 yuan), P<0.01). In the LAS group, 3 patients developed anastomotic leakage requiring reoperation while the RAS group had 1 case of anastomotic stenosis 2 years postoperatively(received second hepaticojejunostomy)and 1 case of incision infection (received incision debridement and dressing of the abscess). Conclusion Robotic‑assisted surgery can be used to treat children with cholangiectasis under 3 months of age and may achieve good results.