1. Safety and feasibility of laparoscopic versus open liver resection with associated lymphadenectomy for intrahepatic cholangiocarcinoma
- Author
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Junjun Han, Weiding Wu, Jia Wu, Chengwu Zhang, Fang Han, Lei Liang, Yuanbiao Zhang, Yuhua Zhang, Junjun Zhao, Jie Liu, Zhiming Hu, and Changwei Dou
- Subjects
Male ,medicine.medical_specialty ,Health (social science) ,Multivariate analysis ,medicine.medical_treatment ,Blood Loss, Surgical ,General Biochemistry, Genetics and Molecular Biology ,Disease-Free Survival ,Cholangiocarcinoma ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Blood loss ,Medicine ,Hepatectomy ,Humans ,Hospital Mortality ,Stage (cooking) ,Laparoscopy ,Propensity Score ,Intrahepatic Cholangiocarcinoma ,Aged ,Retrospective Studies ,Open liver resection ,medicine.diagnostic_test ,business.industry ,Significant difference ,General Medicine ,Length of Stay ,Middle Aged ,Surgery ,Bile Duct Neoplasms ,030220 oncology & carcinogenesis ,Feasibility Studies ,Lymph Node Excision ,030211 gastroenterology & hepatology ,Lymphadenectomy ,Female ,Neoplasm Recurrence, Local ,business - Abstract
The safety and feasibility of laparoscopic versus open liver resection (LLR vs. OLR) associated lymphadenectomy for intrahepatic cholangiocarcinoma (ICC) are still controversial. The aim of the present study was to compare short and long-term outcomes. We reviewed data on 43 consecutive patients who underwent curative liver resection with associated lymphadenectomy for ICC. The short-term outcomes including postoperative morbidity and mortality, and the long-term outcomes including overall survival (OS) and recurrence-free survival (RFS) were compared. The median survival, 1- and 3-year OS in LLR and OLR groups were 22.5 months, 76.9% and 47.1%, and 12.1 months, 43.1% and 20.0%, respectively. The median survival, 1- and 3-year RFS in LLR and OLR groups were 10.3 months, 27.8% and 0%, and 8.1 months, 24.0% and 4.0%, respectively. The results showed that LLR obviously reduced intraoperative blood loss (median, 375 vs. 500ml, p = 0.016) and postoperative hospital stay (median, 6 vs. 9 days, p = 0.016). Moreover, there was no significant difference in short-term outcomes including postoperative morbidity (including wound infection, bile leakage, liver failure and pneumonia) and mortality within 30 days, and long-term outcomes including OS and RFS between LLR and OLR. (all p > 0.05). Multivariate analysis showed that CA19-9 level, TNM stage, and tumor differentiation were independent risk factors for OS and RFS. LLR for ICC is safety and feasibility compared with OLR. The advantage of LLR was to reduce intraoperative blood loss and postoperative hospital stay.
- Published
- 2020