Comparison of perioperative and oncologic outcomes between open and laparoscopic liver resection for intrahepatic cholangiocarcinoma

Surg Endosc. 2016 Nov;30(11):4835-4840. doi: 10.1007/s00464-016-4817-x. Epub 2016 Feb 22.

Abstract

Background: Laparoscopic liver resection (LLR) has become an essential method for treating malignant liver tumors. Although the perioperative and oncologic outcomes of LLR in patients with hepatocellular carcinoma have been reported, there are few reports of LLR for intrahepatic cholangiocarcinoma (IHCC).

Methods: Patients who underwent liver resection for T1 or T2 IHCC between March 2010 and March 2015 in Gyeongsang National University Hospital were enrolled. They were divided into open (n = 23) and laparoscopic (n = 14) approaches, and the perioperative and oncologic outcomes were compared.

Results: The Pringle maneuver was less frequently used (p = 0.015) and estimated blood loss was lesser (p = 0.006) in the laparoscopic group. There were no significant differences in complication rate (p = 1.000), hospital stay (p = 0.371), tumor size (p = 0.159), lymph node metastasis (p = 0.127), and the number of retrieved lymph nodes (p = 0.553). The patients were followed up for a median of 21 months. The 3-year overall survival (OS) and recurrence-free survival (RFS) rates were 74.7 and 55.2 %, respectively. No differences were observed in the 3-year OS (75.7 vs 84.6 %, p = 0.672) and RFS (56.7 vs 76.9 %, p = 0.456) rates between the open and laparoscopic groups, even after the groups were divided into patients that received liver resection with or without lymph node dissection.

Conclusion: LLR for IHCC is a treatment modality that should be considered as an option alongside open liver resection in selected patients.

Keywords: Intrahepatic cholangiocarcinoma; Laparoscopic liver resection; Oncologic outcome; Postoperative complications.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Bile Duct Neoplasms / pathology
  • Bile Duct Neoplasms / surgery*
  • Bile Ducts, Intrahepatic*
  • Biliary Tract Surgical Procedures / methods
  • Cholangiocarcinoma / pathology
  • Cholangiocarcinoma / surgery*
  • Female
  • Follow-Up Studies
  • Hepatectomy / methods*
  • Humans
  • Laparoscopy / methods*
  • Laparotomy / methods
  • Length of Stay
  • Liver Neoplasms / pathology
  • Liver Neoplasms / surgery*
  • Lymph Node Excision / methods
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / epidemiology*
  • Neoplasm Staging
  • Patient Selection
  • Postoperative Complications / epidemiology*
  • Retrospective Studies