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Risk factor analysis of conversion in laparoscopic liver resection for intrahepatic cholangiocarcinoma

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Abstract

Background

The risk factors of patients with intrahepatic cholangiocarcinoma (ICC) requiring conversion to open surgery have not been adequately studied. This study aimed to determine the risk factors and postoperative outcomes of conversion in patients with ICC.

Methods

From May 2014 to September 2022, Unplanned conversions were compared with successful LLRs.

Results

153 patients with ICC initially underwent LLR, of which 41 (26.8%) required conversion to open surgery. Multivariate analysis for those factors that were statistically significant or confirmed by clinical studies, tumor proximity to the major vessels (OR 6.643, P < 0.001), and previous upper abdominal surgery (OR 3.140, P = 0.040) were independent predictors of unplanned conversions. Compared to successful LLRs, unplanned conversions showed longer operative times (300.0 vs. 225.0 min, P < 0.001), more blood loss (500.0 vs. 200.0 mL, P < 0.001), higher transfusion rates (46.3% vs. 11.6%, P < 0.001), longer length of stays (13.0 vs. 8.0 days, P < 0.001), and higher rates of major morbidity (39.0% vs. 11.6%, P < 0.001). However, there was no statistically significant difference in 30-day or 90-day mortality between the conversion group and the laparoscopic group.

Conclusion

Conversion during LLR should be anticipated in ICC patients with prior upper abdominal surgery or tumor proximity to major vessels as features.

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Funding

Funding was provided by National Natural Science Foundation of China (Grant No. 82072625) and Key Research and Development Project of Zhejiang Province (Grant No. 2021C03127).

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Authors and Affiliations

  1. Department of General Surgery, The First People’s Hospital of Jiashan County, No. 1218, South Sports Road, Jiashan, 314100, China

    Yubin Sheng

  2. Department of General Surgery, Zhejiang University, School of Medicine, Sir Run Run Shaw Hospital, 3 East Qingchun Road, Hangzhou, 310016, Zhejiang, China

    Yubin Sheng, Junhao Zheng, Liye Tao, Zefeng Shen & Xiao Liang

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  1. Yubin Sheng
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Correspondence to Xiao Liang.

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Yubin Sheng, Xiao Liang, Junhao Zheng, Liye Tao, and Zefeng Shen have no conflicts of interest or financial ties to disclose.

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Sheng, Y., Zheng, J., Tao, L. et al. Risk factor analysis of conversion in laparoscopic liver resection for intrahepatic cholangiocarcinoma. Surg Endosc 38, 1191–1199 (2024). https://doi.org/10.1007/s00464-023-10579-9

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