Endoscopy · 2026
Safety and feasibility of an ERCP robotic system in patients with common bile duct stones: a propensity score-matched observational study.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Tang Dehua, Yan Ruyan, Zhou Lin, Shen Yonghua, Yang Chun, Yan Peng, Gao Ningjing, Zhang Bin, Shen Shanshan, Fu Ye, Cheng Yuxuan, Zhu Hao, Ni Muhan, Zhang Xiang, Zheng Ruhua, Liu Bingyi, Xie Tianyu, Wang Lei
Аннотация
BACKGROUND: Robotic assistance may mitigate occupational hazards associated with endoscopic retrograde cholangiopancreatography (ERCP). We evaluated the safety, feasibility, and learning curve of a new ERCP robotic system.
METHODS: In this observational study, 26 patients with common bile duct stones underwent robotic-assisted ERCP; 6 underwent biliary cannulation only and 20 underwent stone extraction. For the 20 cases with stone extraction, comparisons were performed using 1:1 propensity score matching (PSM) with conventional ERCP performed by the same operator. The safety outcome was adverse events. Feasibility outcomes included technical success, procedural times, operator radiation exposure, and learning-curve characteristics.
RESULTS: After PSM, adverse event rates were similar between groups. Post-ERCP pancreatitis occurred in 15.0% (3/20, robotic) and 10.0% (2/20, conventional) (P >0.99), with no bleeding, perforation, or procedure-related mortality. Biliary cannulation and stone extraction success rates were 100% (20/20) in both groups. Robotic-assisted ERCP had a longer procedure time (36.6 vs. 17.0 minutes; P < 0.001), but similar cannulation and fluoroscopy times. In robotic-assisted procedures, radiation exposure was markedly lower in the control room than in the operation room (0.10 vs. 1.26 μSv; P < 0.001). Learning-curve analysis suggested performance stabilization after 10-12 cases.
CONCLUSIONS: Robotic-assisted ERCP appeared safe and feasible, with high technical success and substantially reduced operator radiation exposure.
METHODS: In this observational study, 26 patients with common bile duct stones underwent robotic-assisted ERCP; 6 underwent biliary cannulation only and 20 underwent stone extraction. For the 20 cases with stone extraction, comparisons were performed using 1:1 propensity score matching (PSM) with conventional ERCP performed by the same operator. The safety outcome was adverse events. Feasibility outcomes included technical success, procedural times, operator radiation exposure, and learning-curve characteristics.
RESULTS: After PSM, adverse event rates were similar between groups. Post-ERCP pancreatitis occurred in 15.0% (3/20, robotic) and 10.0% (2/20, conventional) (P >0.99), with no bleeding, perforation, or procedure-related mortality. Biliary cannulation and stone extraction success rates were 100% (20/20) in both groups. Robotic-assisted ERCP had a longer procedure time (36.6 vs. 17.0 minutes; P < 0.001), but similar cannulation and fluoroscopy times. In robotic-assisted procedures, radiation exposure was markedly lower in the control room than in the operation room (0.10 vs. 1.26 μSv; P < 0.001). Learning-curve analysis suggested performance stabilization after 10-12 cases.
CONCLUSIONS: Robotic-assisted ERCP appeared safe and feasible, with high technical success and substantially reduced operator radiation exposure.