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Laparoscopic liver resection as a treatment option for intrahepatic cholangiocarcinoma

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Abstract

Laparoscopic liver resection (LLR) remains controversial in the treatment of intrahepatic cholangiocarcinoma (ICC). The aim of the present study is to investigate the outcomes of LLR for ICC compared to open liver resection (OLR). We retrospectively reviewed patients who underwent surgery for ICC between January 2013 and February 2020. OLR and LLR were compared after propensity score matching (PSM). Overall survival (OS) and recurrence-free survival (RFS) were compared between the matched groups. During the study period, 219 patients met the inclusion criteria (OLR = 170 patients, 77.6%; LLR = 49 patients, 22.4%). Two groups of 43 patients each were analyzed after PSM. The 5-year RFS and OS were 44.6% and 47.9% in the OLR group and 50.9% and 39.8% in the LLR group, respectively. Hospital stay and intensive care unit care were significantly shorter and lower in the LLR group than in the OLR group, respectively. Total postoperative complications and complication rates for those Clavien–Dindo grade 3 or higher were similar between the OLR group and the LLR group. Multiple tumors and lymph node metastases were predisposing factors for tumor recurrence and death in multivariate analysis. The present study suggests that LLR should be considered in selective ICC because of short hospitalization and similar oncologic outcome and overall survival.

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Data availability statement

Original patient data supporting this study are available from the corresponding author upon reasonable request.

Abbreviations

BMI:

Body mass index

CA:

Carbohydrate antigen

EBL:

Estimated blood loss

HCC:

Hepatocellular carcinoma

ICC:

Intrahepatic cholangiocarcinoma

ICU:

Intensive care unit

LLR:

Laparoscopic liver resection

LN:

Lymph node

LND:

Lymph node dissection

OLR:

Open liver resection

OS:

Overall survival

PSM:

Propensity score matching

RFS:

Recurrence-free survival

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Acknowledgements

This research was supported by Inha University and an Inha University Hospital Research Grant, and also by the Basic Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science and ICT (NRF-2023R1A2C2005946).

Funding

The authors declare that no funding was received for this study.

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Author notes

  1. Kyeong Deok Kim and Ji Eun Lee contributed equally to this study as co-first authors.

Authors and Affiliations

  1. Department of Surgery, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea

    Kyeong Deok Kim

  2. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06355, Republic of Korea

    Kyeong Deok Kim, Jongman Kim, Jinsoo Rhu, Gyu-Seong Choi, Jin Seok Heo & Jae-Won Joh

  3. Department of Radiology, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, Republic of Korea

    Ji Eun Lee

  4. Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Republic of Korea

    Junsoo Ro

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Contributions

Conceptualization: Jong Man Kim. Methodology: Jong Man Kim. Formal analysis and investigation: Kyeong Deok Kim, Junsoo Ro. Writing—original draft preparation: Kyeong Deok Kim, Ji Eun Lee. Writing—review and editing: Jong Man Kim, Jinsoo Rhu, Gyu-Seong Choi, Jin Seok Heo. Supervision: Jong Man Kim, Jae-Won Joh.

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Correspondence to Jongman Kim.

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The authors of this manuscript have no conflicts of interest to disclose.

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This retrospective study was approved by the institutional review board (IRB) of our institution (IRB no. 2022-03-024), which also waived the need for informed consent.

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Kim, K.D., Lee, J.E., Kim, J. et al. Laparoscopic liver resection as a treatment option for intrahepatic cholangiocarcinoma. Updates Surg (2024). https://doi.org/10.1007/s13304-024-01803-9

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