Surgical outcomes of laparoscopic versus open liver resection for intrahepatic cholangiocarcinoma: Multicenter study

초록

Background and aims: Laparoscopic liver resection (LLR) remains controversial in the treatment of intrahepatic cholangiocarcinoma (IHCCC). The aim of the present study is to investigate the outcomes of LLR for IHCCC compared to open liver resection (OLR). Method: We retrospectively reviewed patients who underwent hepatectomy for IHCCC from six medical centers between January 2013 and February 2020. During the study period, 616 patients met the inclusion criteria (OLR = 514 patients and LLR = 102 patients). Results: The median operation time and median blood loss in the LLR group were significantly shorter and less blood loss than in the OLR group. In addition, the incidence of sever postoperative complications in the LLR group was significantly less than in the OLR group. The cumulative disease-free survival and overall survival are comparable between the two groups. Multivariate analyses showed that multiple tumors, R1 resection, intrahepatic metastasis, and metastatic lymph node were predisposing factors for tumor recurrence. Increased age, long operation time, and multiple tumors were closely associated with mortality. Conclusion: The present study suggests that LLR should be considered in selective IHCCC because of better postoperative short outcomes and comparable disease-free survival and overall survival compared with OLR group.