ROBOTIC RESECTION OF CHOLEDOCHAL CYST WITH ROUX-EN-Y RECOSTRUCTION dr.torices.dardon@gmail.com

 

ROBOTIC RESECTION OF CHOLEDOCHAL CYST WITH ROUX-EN-Y RECOSTRUCTION

3

Mexico

Video

Choledochal cysts are congenital dilatations of the intra- or extrahepatic biliary tract. Their incidence is low, and they occur more frequently in young women. The Todani classification describes five types, with type IV-A affecting both biliary systems. Robotic surgery offers advantages over laparoscopy, including greater precision, three-dimensional visualization, and faster recovery. A case successfully treated using this approach is presented.

Female, 22 years old. History of cardiac arrhythmia treated during childhood, with no subsequent follow-up. The current condition began on August 28, 2024, with a picture of biliary colic and CT revealed a hypodense lesion compatible with a septated hepatic cyst vs. a cluster of cysts. Magnetic resonance cholangiopancreatography showed dilatation of the intra- and extrahepatic biliary tract with an 11.4-cm choledochal cyst, Todani type IV-A

An initial laparoscopic cholecystectomy was performed, and the patient was later scheduled for choledochal cyst resection and biliary reconstruction with a Roux-en-Y hepaticojejunostomy. Surgery on September 20, 2024: performed under general anesthesia with robotic assistance. A dilated biliary tract was identified, preserving vascular structures. Distal resection at the pancreatic level and end-to-side reconstruction with 4-0 prolene suture were performed. Mechanical jejuno-jejunostomy console time: 282 minutes. Discharged on postoperative day 5.

Robotic resection of a Todani type IV-A choledochal cyst with hepaticojejunostomy reconstruction offers a modern alternative with optimal functional outcomes and lower morbidity compared with the conventional approach. This case reinforces the usefulness of robotic surgery in the management of complex congenital biliary pathologies, in alignment with international evidence.

https://vimeo.com/1139138805