To explore the safety and clinical effect of the robotic hepatobiliary and pancreatic surgery combined with vascular resection and reconstruction.

From Jan. 2016 to Oct. 2019, the clinical data of 14 cases of robotic hepatobiliary and pancreatic surgery with vascular resection and reconstruction completed in the second department of hepatobiliary surgery of the First Medical Center of PLA General Hospital were analyzed retrospectively.

All the 14 operations were successfully completed under the daVinci robotic system, without conversion to laparotomy, and without thromboembolism occlusion in the early stage after revascularization. 10 cases were reconstructed by combined partial portal vein resection, of which 2 cases were used artificial blood vessels, 3 cases were combined with partial artery resection and reconstruction, and 1 case was combined with partial middle hepatic vein resection and reconstruction. The average operation time was (294.9 ± 80.7) min, intraoperative bleeding volume was 150 ml, postoperative average hospital stay was (12.0 ± 5.1) days, and perioperative death was 0. Among the 14 cases, 13 achieved R0 resection (92.9%). As of Jan. 2020, 1 case of solid pseudopapilloma of the pancreas has been followed up for 3 years without recurrence, and 13 cases of malignant tumors have been followed up for an average of 15.5 months. Among them, 3 cases of pancreatic cancer died due to recurrence, with a median survival period of 14 months. One case of hilar cholangiocarcinoma died due to recurrence 26 months after operation, and the remaining 9 surviving patients are still in the follow-up.

The combination of vascular resection and reconstruction under the daVinci robotic system is safe and feasible, and its oncology advantages need to be further evaluated.