Scholarlink

Background <p>Robotic cholecystectomy (RCHOLE) is being used more frequently for elective patients. We aimed to compare clinical outcomes, specifically conversion to open/subtotal cholecystectomy, for RCHOLE and laparoscopic cholecystectomy (LCHOLE).</p> Methods <p>Our study received a Non-Human Subjects Research Determination. We studied elective laparoscopic (LCHOLE) and robotic (RCHOLE) cases from 2020 to 2022 using de-identified extraction of electronic US hospital health record data from the Intuitive Custom Hospital Analytics database. LCHOLE and RCHOLE cases, conversion to open/subtotal cholecystectomy, and complications were identified using ICD10 and/or CPT codes. Patients with missing operative times and demographics were excluded (n = 11,276). We used Multivariate Logistic Regression with Inverse Probability Treatment Weighting(MLR/IPTW) to balance covariates. R 4.1.1 was used for analysis.</p> Results <p>LCHOLE(n = 93,122) and RCHOLE(n = 23,581) had similar mean age(50&#xa0;years) and gender(70% female); RCHOLE patients were more frequently obese(BMI ≥ 30&#xa0;kg/m2, 38.0% vs. 33.4%, <i>p</i> &lt; 0.001). Operative time was longer in RCHOLE(107 ± 53 vs. 93 ± 42&#xa0;min, <i>p</i> &lt; 0.001). After MLR/IPTW, RCHOLE had decreased odds of conversion to open cholecystectomy (OR 0.51 [95%CI 0.42, 0.61, <i>p</i> &lt; 0.001), but similar odds of subtotal cholecystectomy. Readmission (OR 0.89 [0.81, 0.97, <i>p</i> = 0.008]) hospital acquired conditions (OR 0.71 [0.60, 0.83, <i>p</i> &lt; 0.001]), and bile duct injury (OR 0.00, <i>p</i> &lt; 0.001) were less likely with RCHOLE.&#xa0;Odds of surgical site infection and hospital mortality were similar in both groups.</p> Conclusions <p>In the elective setting, robotic cholecystectomy has reduced odds of conversion to open, readmission, and hospital acquired conditions including bile duct injury when compared to laparoscopic cholecystectomy.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Robotic Care Outcomes Project (ROBOCOP) for elective cholecystectomy

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年8月26日

查看全文
  • Marc Abou Assali,
  • Yanli Li,
  • Hannah Bossie,
  • Christopher Neighorn,
  • Esther Wu,
  • Kaushik Mukherjee

摘要

Background

Robotic cholecystectomy (RCHOLE) is being used more frequently for elective patients. We aimed to compare clinical outcomes, specifically conversion to open/subtotal cholecystectomy, for RCHOLE and laparoscopic cholecystectomy (LCHOLE).

Methods

Our study received a Non-Human Subjects Research Determination. We studied elective laparoscopic (LCHOLE) and robotic (RCHOLE) cases from 2020 to 2022 using de-identified extraction of electronic US hospital health record data from the Intuitive Custom Hospital Analytics database. LCHOLE and RCHOLE cases, conversion to open/subtotal cholecystectomy, and complications were identified using ICD10 and/or CPT codes. Patients with missing operative times and demographics were excluded (n = 11,276). We used Multivariate Logistic Regression with Inverse Probability Treatment Weighting(MLR/IPTW) to balance covariates. R 4.1.1 was used for analysis.

Results

LCHOLE(n = 93,122) and RCHOLE(n = 23,581) had similar mean age(50 years) and gender(70% female); RCHOLE patients were more frequently obese(BMI ≥ 30 kg/m2, 38.0% vs. 33.4%, p < 0.001). Operative time was longer in RCHOLE(107 ± 53 vs. 93 ± 42 min, p < 0.001). After MLR/IPTW, RCHOLE had decreased odds of conversion to open cholecystectomy (OR 0.51 [95%CI 0.42, 0.61, p < 0.001), but similar odds of subtotal cholecystectomy. Readmission (OR 0.89 [0.81, 0.97, p = 0.008]) hospital acquired conditions (OR 0.71 [0.60, 0.83, p < 0.001]), and bile duct injury (OR 0.00, p < 0.001) were less likely with RCHOLE. Odds of surgical site infection and hospital mortality were similar in both groups.

Conclusions

In the elective setting, robotic cholecystectomy has reduced odds of conversion to open, readmission, and hospital acquired conditions including bile duct injury when compared to laparoscopic cholecystectomy.