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Laparoscopic versus open surgery for hilar cholangiocarcinoma: a retrospective cohort study on short-term and long-term outcomes

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Abstract

Background

Laparoscopic surgery (LS) for hilar cholangiocarcinoma (HCCa) remains under development, and its feasibility and safety remain controversial. This study therefore evaluated the outcomes of this technique and compared them to those of open surgery (OS).

Methods

In total, 149 patients underwent surgical resection for HCCa at our center between February 2017 and September 2020. After screening and propensity score matching, 47 OS group patients and 20 LS group patients remained, and their baseline characteristics, pathologic findings, surgical outcomes, and long-term outcomes were compared.

Result

The baseline characteristics and pathologic findings were comparable between the two groups. The mean incision length was longer in the OS group than in the LS group (21.0 cm vs. 13.2 cm, P < 0.001). No significant differences were observed in the other surgical outcomes between the two groups. Regarding long-term outcomes, the overall survival rate and disease-free survival rate of the OS group were significantly higher than those of the LS group (P = 0.0057, P = 0.043). However, the two groups had significantly different follow-up times (19.2 months vs. 14.7 months, P = 0.041).

Conclusion

LS for HCCa is technically achievable, and our study revealed that it is equivalent to OS in terms of short-term outcomes but was poorer in terms of long-term outcomes.

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Abbreviations

HCCa:

Hilar cholangiocarcinoma

LS:

Laparoscopic surgery

OS:

Open surgery

PSM:

Propensity score matching

PTBD:

Percutaneous transhepatic biliary drainage

ASA:

American Society of Anesthesiology

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Acknowledgements

We would like to thank American Journal Experts for assistance with language editing.

Funding

This study was funding by Key Research and Development Plan of Shandong Province (2019GSF108012).

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Author notes

  1. Delin Ma and Wei Wang contributed to the work equally and should be regarded as co-first authors.

Authors and Affiliations

  1. Department of Surgery, School of Medicine, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, Shandong, China

    Delin Ma & Wei Wang

  2. Department of Organ Transplantation, Qilu Hospital, Cheeloo College of Medicine, Shandong University, 107 Wenhuaxi Road, Jinan, 250012, Shandong, China

    Delin Ma, Jianlei Wang, Tingxiao Zhang, Zhaochen Jiang, Gang Du, Jinhuan Yang & Bin Jin

  3. School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, Shandong, China

    Xiqing Zhang

  4. Department of Hepatobiliary Surgery, Xuchang Central Hospital Affiliated to Henan University of Science and Technology, Xuchang, 461000, Henan, China

    Guanjun Qin

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  1. Delin Ma
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Correspondence to Bin Jin.

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Delin Ma, Wei Wang, Jianlei Wang, Tingxiao Zhang, Zhaochen Jiang, Gang Du, Jinhuan Yang, Guanjun Qin, Xiqing Zhang and Bin Jin have no conflicts of interest or financial ties to disclose.

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Ma, D., Wang, W., Wang, J. et al. Laparoscopic versus open surgery for hilar cholangiocarcinoma: a retrospective cohort study on short-term and long-term outcomes. Surg Endosc 36, 3721–3731 (2022). https://doi.org/10.1007/s00464-021-08686-6

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