BACKGROUND: We conducted this retrospective study to investigate the characteristics of the learning curve of total robotic jejunojejunostomy during choledochal cyst excision in pediatrics. METHODS: The study analyzed a database of medical records from the first 54 consecutive patients who underwent total robotic jejunojejunostomy during choledochal cyst excision by a single surgeon. Baseline information and postoperative outcomes were collected, and learning curves were assessed using the cumulative sum (CUSUM) method. Patients were then divided into two groups (A and B) based on the learning curve's cut-off points, and the intraoperative characteristics and postoperative outcomes were compared between the two groups. RESULTS: CUSUM plots revealed that the cut-off point of the learning curve was 17 cases. The operative time of jejunojejunostomy in group A was (61.71 ± 13.47 min), which was longer than that of group B (42.43 ± 2.97 min) (p <
0.0001). No statistically significant differences were found in terms of the intraoperative bleeding, time to start diet after surgery, hospital stay, and total complications between the two groups (p >
0.05). CONCLUSION: The learning curve for total robotic jejunojejunostomy during choledochal cyst excision in pediatrics is 17 cases, which can serve as the basis for performance guidance during future training.