A narrative review of robotic approaches to bile duct injury: optimizing surgical outcomes

Although very rare after cholecystectomy, iatrogenic bile duct injury (BDI) is the most feared complication. Rarely other causes such as abdominal trauma may cause a BDI. Management required high quality imaging, possibly biliary drainage, control of biliary sepsis, identification of concomitant vasculo-biliary injury (VBI) and referral to a specialty hepatobiliary (HPB) surgeon for definitive repair. Due to the complexity of the injury and possibly hostile operative field the literature often recommends open repairs. With current technical advances these BDI cases can often be repaired robotically. In this review, we aim to discuss an update on the basic principles, technical aspects, and limitations of robotic reconstruction of BDI and offer our conditional recommendations.