Liver resection for extra-pancreatic biliary cancer: what is the role of laparoscopic approach?

  • Walid ElmoghazyEmail author
  • Jane Cowan
  • Nicolas Tabchouri
  • Pascale Tinguely
  • Mostefa Bennamoun
  • Candice Tubbax
  • Anthony Sarran
  • Marine Lefevre
  • Christian Lamer
  • Brice Gayet
  • David Fuks



Laparoscopic liver resection (LLR) has evolved over time, yet its role in extra-pancreatic biliary cancer has been limited due to several factors. We aimed to evaluate the short-term outcome of LLR in extra-pancreatic biliary tract cancer.


From January 2002 to 2016, all patients who underwent LLR for extra-pancreatic biliary tract cancer including gallbladder cancer (GBC), intra-hepatic cholangiocarcinoma (ICC), and peri-hilar cholangiocarcinoma (PHC) with curative intent (R0 or R1) at Institute Mutualiste Montsouris were identified from prospectively collected databases. Patient characteristics, and perioperative outcomes, were analyzed in all three groups.


A total of 35 patients were included: 10 with GBC, 14 with ICC, and 11 with PHC. There were 19 (54%) women and median age was 71 years. Median operative time was 240 min, and estimated blood loss was 200 ml. Conversion to an open procedure was more common in patients with PHC (45% vs. 7% for ICC and 0% for GBC, p = 0.010). R0 resection was achieved in 10 (100%), 12 (86%), and 8 (73%) patients in GBC, ICC, and PHC groups, respectively (p = 0.204). Postoperative morbidity was reported in 19 (54%) patients of whom 12 (34%) had minor complications. Postoperative mortality was reported in 4 (11%) patients; one (7%) in GBC group, one (7%) in ICC group, and two (18%) in PHC, p = 0.681. Median hospital stay was 11 days.


The present series suggests that LLR is feasible in GBC, challenging but achievable in ICC but unsuitable for the moment in PHC.


Laparoscopy Liver resection Biliary tract malignancy Short-term outcome Complications 



Laparoscopic liver resection


American Society of Anesthesiologists


Body mass index


Computed tomography


Compliance with ethical standards


Walid Elmoghazy, Jane Cowan, Nicolas Tabchouri, Pascale Tinguely, Mostefa Bennamoun, Candice Tubbax, Anthony Sarran, Marine Lefevre, Christian Lamer, Brice Gayet, and David Fuks have no conflict of interests or financial ties to disclose.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Walid Elmoghazy
    • 1
    • 2
    Email author
  • Jane Cowan
    • 1
  • Nicolas Tabchouri
    • 1
  • Pascale Tinguely
    • 1
  • Mostefa Bennamoun
    • 3
  • Candice Tubbax
    • 1
  • Anthony Sarran
    • 4
  • Marine Lefevre
    • 5
  • Christian Lamer
    • 6
  • Brice Gayet
    • 1
    • 7
  • David Fuks
    • 1
    • 7
  1. 1.Department of Digestive, Oncological and Metabolic Surgery – Institut Mutualiste MontsourisParisFrance
  2. 2.Department of SurgerySohag UniversitySohagEgypt
  3. 3.Department of Oncology – Institut Mutualiste MontsourisParisFrance
  4. 4.Department of Radiology – Institut Mutualiste MontsourisParisFrance
  5. 5.Department of Pathology – Institut Mutualiste MontsourisParisFrance
  6. 6.Department of Intensive Care Unit – Institut Mutualiste MontsourisParisFrance
  7. 7.Université Paris DescartesParisFrance

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