Robotic reoperative management of recurrent gallbladder disease after subtotal cholecystectomy: a contemporary single-institution experience.

BACKGROUND

The increasing adoption of incomplete cholecystectomy in severe cholecystitis has created a growing population of patients who later develop recurrent symptoms from remnant gallbladder or cystic duct pathology. Reoperative cholecystectomy is definitive but technically challenging, and the role of robotic surgery in this setting remains poorly defined.

METHODS

A retrospective cohort study was performed of adult patients undergoing robot-assisted completion or remnant cholecystectomy for recurrent gallbladder disease at a single tertiary institution between 2022 and 2024. Perioperative outcomes were evaluated, and institutional primary cholecystectomy outcomes were used as a contextual comparator.

RESULTS

Twenty-one patients underwent robotic reoperative cholecystectomy. The median age was 41 years, and most patients were female and obese. All had radiographic evidence of remnant biliary pathology. The median operative time was 166 min, with no intraoperative complications or conversions to open surgery. The median postoperative length of stay was 0 days, with most patients discharged the same day. One patient experienced a 30-day major complication managed nonoperatively. There were no 90-day readmissions or mortalities, and all patients reported symptom resolution.

DISCUSSION: In this single-institution series, robotic reoperative cholecystectomy was safe and effective, with minimal morbidity, very short hospital stays, and universal symptom resolution. When performed at experienced centers, robotic reoperative cholecystectomy represents an effective definitive strategy for recurrent gallbladder disease after incomplete cholecystectomy.