Background : While simple laparoscopic cholecystectomy is adequate for the treatment of early gallbladder cancer (GBC), minimally invasive surgery (MIS) is not widely accepted since advanced GBCs necessitate the adaptation of complicated techniques including lymph node dissection and liver resection. Robotic extended cholecystectomy (REC) is thought to be able to overcome the limitations of MIS, but clinical outcome studies are lacking. Therefore, we aimed to determine the efficacy of REC, the clinical outcomes of REC were compared to those of open extended cholecystectomy (OEC).

Methods : 125 patients with extended cholecystectomy between 2018 and 2021 were included in the study. Of these, 41 patients underwent REC, and 84 patients underwent OEC. We analyzed the difference in clinical outcomes by the surgical method.

Results : REC group had a significantly reduced estimated blood loss (EBL) compared to OEC group. The operation time, number of retrieved lymph nodes, number of metastatic lymph nodes, the incidence of postoperative complications did not differ significantly between the groups. Meanwhile, the REC group had significantly lower subjective pain scores than the OEC group from the day of surgery through the fifth postoperative day. However, there was no significant difference between the two groups in the 3-year survival rate (91.7% vs. 93.0%, P = 0.761).

Conclusions : In this study, we found that REC has the advantage of lower EBL and pain intensity than OEC. For advanced GBCs, REC may be a more desirable option than OEC. Further studies are required to validate these results.