Robotic Liver Resection for Gallbladder Cancer, Hilar Lymphadenectomy, and Biliary Reconstruction

Gallbladder carcinoma although rare (1.2% of cancer diagnoses worldwide) is an especially aggressive malignancy with 84,695 deaths in 2020 according to the World Health Organization [1]. Four out of five cases have spread beyond the gallbladder at the time of diagnosis, and the overall estimated 5-year survival for patients with gallbladder cancer is 19%. Survival rates drastically decline when tumor has metastasized to regional lymph nodes from 65% 5-year survival for localized disease to 28% with regional nodal spread. Those with distant metastasis at the time of diagnosis have about a 2% 5-year survival rate [2]. Treatment options are patient dependent and include surgical resection, chemotherapy, radiation, or a combination. Currently, except for few smaller studies, there is little research to support neoadjuvant vs adjuvant systemic therapy, and surgical resection is the mainstay for resectable disease [3].