Robotic Assisted Portal Lymphadenectomy and Partial Hepatectomy for Incidentally Discovered Gallbladder Adenocarcinoma

Zeljka Jutric, MD1, Chet W Hammill, MD, MCR2. 1Portland Providence Cancer Center, 2The Oregon Clinic

Gallbladder carcinoma can be incidentally identified after laparoscopic cholecystectomy. Our patient is a 61 year old, otherwise healthy female, who was diagnosed with a T1b adenocarcinoma incidentally after cholecystectomy for symptomatic cholelithiasis.

We perform a robotic-assisted portal lymphadenectomy and a hepatectomy involving a 2 cm resection of segments IVb and V. We outline the relevant anatomy of the porta hepatis while performing a portal lymphadenectomy.

We found the combination of the ultrasonic dissector, the bipolar vessel sealer and clips for larger vessels to be very effective in the minimally invasive approach to liver resection, and we describe these methods in the video.

Our patient’s liver resection and cystic duct stump margins were negative, as were all of her lymph nodes. She was discharged home on post-operative day three and continues to do well. 

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