The Use of Robotic Surgery to Perform a Central Hepatectomy Enlarged to Segment 1 Due to a Cholangiocarcinoma

The cholangiocarcinoma or biliary duct neoplasia originates in the epithelia of the hepatic ducts. Although rare, they have an elevated mortality rate, because at the diagnosis, the vast majority of them are in advanced stages. They account for 3% oF gastrointestinal neoplasias, and >90% are adenocarcinomas.Anatomically, the intrahepatic cholangiocarcinomas have their origin in the intrahepatic ductules, or in the intrahepatic ducts proximal to the bifurcation of de common hepatic duct.The intrahepatic disease accounts for less than 10% of the cases.The treatment consists of surgical resection. The overall survival at 5 years, after surgery ranges from 11 to 40%, but in patients with R0 resections, and negative nodes it can reach the 63%. Still the vast majority of the patients recur after a potentially curative surgery.We present the case of a 76 year old female, with diabetes, high blood pressure and breast cancer, that in2022, was diagnosed with an intrahepatic cholangiocarcinoma, without metastasis. The patient was proposed for a robotic mesohepatectomy. The surgery had no intercurrences, as well as the post operative time. The pathological assessment revealed a intrahepatic cholangicarcinoma pT2N0, R0.The robotic surgery has shown to be a great ally in hepatic surgery. It allows for a delicate and precise approach, with all the benefits associated with a minimally invasive technique.