Robotic bile duct exploration linked to better perioperative outcomes in retrospective study

Researchers retrospectively compared robot-assisted common bile duct exploration (RCBDE) with conventional laparoscopic exploration (LCBDE) at one hospital in China from January 2023 to June 2025. The study included 331 patients with common bile duct stones at least 1.0 cm in diameter: 107 underwent RCBDE and 224 LCBDE. Propensity score matching produced 106 pairs. Outcomes included operative measures, complications, recovery, length of stay and hospitalization cost; outcomes were also assessed by the presence of hilar adhesions.

Compared with LCBDE, RCBDE was associated with shorter bile duct suturing time, less blood loss, fewer bowel injuries, less need for additional trocar placement and fewer conversions to open surgery. After matching, the robotic group also had fewer overall complications and less bile leakage, faster bowel recovery, shorter drainage duration and shorter postoperative hospital stay. Total hospitalization cost was higher with RCBDE. Hilar adhesions were independently associated with postoperative complications and bowel injury, while the study reported favorable RCBDE outcomes in patients with adhesions.

The findings suggest potential perioperative advantages in this selected patient group, but do not establish that the robotic approach causes better outcomes. This was a retrospective, single-center comparison, and the abstract provides no event counts or effect estimates. The results may not generalize to patients with smaller stones or other care settings.