The Role of Robotic Surgery in the Klatskin Tumor

The cholangiocarcinoma or biliary duct neoplasia originates in the epithelia of the hepatic ducts. Although rare, they have an elevated mortality rate, because, at diagnosis, most of them are in advanced stages. The cholangiocarcinomas that involve the split of the common bile duct, are termed Klatskin tumors or hilar cholangiocarcinomas. They account for 50% of all cholangiocarcinomas, and of these about 40% are distal extra hepatic, and only 10% have an intrahepatic origin.Globally they have a poor prognosis, with an overall survival at 5 years of 5 to 10% in the metastatic disease. Surgery is the only chance for cure, particularly for the distal cholangiocarcinomas, which are the most amenable to resection.We present the case of a 70 year old male diagnosed with a peri-hilar cholangiocarcinoma Bismuth Corlette type 1, without metastasis. The patient was proposed for a bile duct resection with a hepaticojejunostomy and lymphadenectomy by robotic surgery. The pathological assessment revealed an adenocarcinoma of the extrahepatic bile duct, G3, pT1N0. The use of robotic surgery is being widespread, allowing for a more delicate and precise approach in hepatic surgery, with short hospital stay, faster recovery and less complications, which associated with an early diagnosis of this entity ends up being the only chance of a good outcome for the patient.