肝门胆管癌是一种治疗困难的癌症，常伴有血管侵犯、局部复发和生存率低。由于需要胆管吻合和潜在的血管切除，标准手术方法是开放手术。在高级别中心零星报告了腹腔镜切除后的次优结果。在这项首次、跨大西洋的多中心研究中，我们报告了我们对肝门胆管癌机器人切除的结果。这是西半球规模最大的研究。从2016年到2023年，我们对三个高级别机器人肝脏手术中心中进行机器人切除的肝门胆管癌患者进行了前瞻性随访。38例患者采用机器人技术进行肝门胆管癌切除，其中Klatskin 3型最为常见。中位年龄为72岁，82%的患者在手术前进行了胆管引流。中位手术时间为481分钟，中位估计失血量为200毫升。收取的淋巴结数量为7个，11例（28%）患者的淋巴结呈阳性。3例患者需要血管重建；18%的患者有多个胆管吻合口。82%的患者实现了R0切缘切除。16%的患者出现Clavien-Dindo 分级≥3的并发症。住院时长为6天。五名患者在30天内发生了非计划再次入院。一名患者在30天内死亡。中位随访时间为15个月，68%的患者存活无病，13%复发，19%死亡。机器人技术在肝门胆管癌的应用是安全和可行的，具有可接受的短期临床和肿瘤学结局。© 2023. 外科肿瘤学学会。

Perihilar cholangiocarcinoma is a difficult cancer to treat with frequent vascular invasion, local recurrence, and poor survival. Due to the need for biliary anastomosis and potential vascular resection, the standard approach is an open operation. Suboptimal outcomes after laparoscopic resection had been sporadically reported by high-volume centers. In this first, Trans-Atlantic, multicenter study, we report our outcomes of robotic resection for perihilar cholangiocarcinoma. This is the largest study of its kind in the Western hemisphere.Between 2016 and 2023, we prospectively followed patients undergoing robotic resection for perihilar cholangiocarcinoma at three, high-volume, robotic, liver-surgery centers.Thirty-eight patients underwent perihilar cholangiocarcinoma utilizing the robotic technique; Klatskin type-3 was the most common. The median age was 72 years, and 82% of the patients underwent preoperative biliary drainage. Median operative time was 481 minutes with a median estimated blood loss of 200 mL. The number of harvested lymph nodes was seven, and 11 (28%) patients yielded positive lymph nodes. Three patients required vascular reconstruction; 18% of patients had >1 biliary anastomosis. R0 resection margins were achieved in 82% of patients. Clavien-Dindo Grade ≥3 complications were seen in 16% of patients. The length of stay was 6 days. Five patients had an unplanned readmission within 30 days. One patient died within 30 days. With a median follow-up of 15 months, 68% of patients are alive without disease, 13% recurred, and 19% died.Application of the robotic platform for perihilar cholangiocarcinoma is safe and feasible with acceptable short-term clinical and oncological outcomes.© 2023. Society of Surgical Oncology.