{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T02:35:09Z","timestamp":1774060509091,"version":"3.50.1"},"reference-count":33,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,3,18]],"date-time":"2019-03-18T00:00:00Z","timestamp":1552867200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Presently, experience with robotic biliary surgery (RBS) is increasing worldwide although widespread adoption remains limited. In this study, we report our initial experience with RBS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective review of a single institution prospective database of 95 consecutive robotic hepatopancreatobiliary surgeries performed between 2013 and 2018. Of these, 27 patients who underwent RBS were included in this study. RBS was performed by three principal console surgeons of whom one surgeon performed 23 (85%) and supervised all cases. Additionally, to evaluate our initial outcomes with bilio\u2010enteric anastomoses, eight consecutive pancreatoduodenectomies were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 27 RBS performed, these included 10 hepaticojejunostomies with bile duct resections (including two concomitant pancreatoduodenectomies and one right hepatectomy) for choledochal cysts, bile duct strictures and biliary malignancies; five liver resections with hilar lymph node clearance for gallbladder cancer; four for Mirizzi syndrome; two cholecystectomies with cholecystoenteric fistula and two bile duct exploration after failed endoscopic treatment of choledocholithiasis. There were no open conversions, no 90\u2010day mortality and four (14.8%) major (&gt;Grade II) morbidities. The median post\u2010operative stay was 6 (range 1\u201329) days and there was one (3.7%) 30\u2010day readmissions. Of our first 18 robotically constructed bilio\u2010enteric anastomoses, there was only one (5.5%) early anastomotic complication (bile leak requiring reoperation).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our initial experience demonstrated that RBS can be adopted safely with a low open conversion rate. Robotically constructed bilio\u2010enteric anastomosis can be performed safely with a low anastomotic complication rate.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.15135","type":"journal-article","created":{"date-parts":[[2019,3,19]],"date-time":"2019-03-19T22:49:28Z","timestamp":1553035768000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Initial single institution experience with robotic biliary surgery and bilio\u2010enteric anastomosis in southeast Asia"],"prefix":"10.1111","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8218-4576","authenticated-orcid":false,"given":"Brian K. P.","family":"Goh","sequence":"first","affiliation":[{"name":"Department of Hepatopancreatobiliary and Transplant Surgery Singapore General Hospital  Singapore"},{"name":"Duke\u2010NUS Medical School  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tze\u2010Yi","family":"Low","sequence":"additional","affiliation":[{"name":"Department of Hepatopancreatobiliary and Transplant Surgery Singapore General Hospital  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin\u2010Yao","family":"Teo","sequence":"additional","affiliation":[{"name":"Department of Hepatopancreatobiliary and Transplant Surgery Singapore General Hospital  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ser\u2010Yee","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Hepatopancreatobiliary and Transplant Surgery Singapore General Hospital  Singapore"},{"name":"Duke\u2010NUS Medical School  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chung\u2010Yip","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Hepatopancreatobiliary and Transplant Surgery Singapore General Hospital  Singapore"},{"name":"Duke\u2010NUS Medical School  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander Y. 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