Laparoscopic versus open resection of intrahepatic cholangiocarcinoma: nationwide analysis
Author:
Hobeika C12ORCID, Cauchy F1ORCID, Fuks D3ORCID, Barbier L4, Fabre J M5, Boleslawski E6, Regimbeau J M7ORCID, Farges O1, Pruvot F R6, Pessaux P8, Salamé E4, Soubrane O1, Vibert E9, Scatton O2, Goumard C, Gayet B, Cherqui D, Nomi T, Oudafal N, Kawai T, Komatsu S, Okumura S, Petrucciani N, Laurent A, Bucur P, Trechot B, Nunèz J, Tedeschi M, Allard M.-A, Golse N, Ciacio O, Pittau G, Sa Cunha A, Adam R, Laurent C, Chiche L, Leourier P, Rebibo L, Ferre L, Souche F R, Chauvat J, Jehaes F, Mohkam K, Lesurtel M, Ducerf C, Mabrut J.-Y, Hor T, Paye F, Balladur P, Suc B, Muscari F, Millet G, El Amrani M, Ratajczak C, Lecolle K, Truant S, Kianmanesh A.-R, Codjia T, Schwarz L, Girard E, Abba J, Letoublon C, Chirica M, Carmelo A, VanBrugghe C, Cherkaoui Z, Unterteiner X, Memeo R, Buc E, Lermite E, Barbieux J, Bougard M, Marchese U, Ewald J, Turini O, Thobie A, Menahem B, Mulliri A, Lubrano J, Zemour J, Fagot H, Passot G, Gregoire E, Hardwigsen J, le Treut Y.-P, Patrice D,
Affiliation:
1. Department of Hepatobiliary Surgery and Liver Transplantation, Hôpital Beaujon, Assistance Publique-Hopitaux de Paris, Université de Paris, Paris, France 2. Department of Hepatobiliary Surgery and Liver Transplantation, Hôpital de la Pitié Salpêtrière, Assistance Publique-Hopitaux de Paris and Sorbonne University, Paris, France 3. Department of Digestive Surgery, Institut Mutualiste Montsouris, Université Paris V, Paris, France 4. Department of Digestive, Endocrine, Hepatopancreatobiliary Surgery and Liver Transplantation, Hôpital Trousseau, Centre Hospitalier Régional Universitaire Tours, Tours, France 5. Department of Digestive, Hepatopancreatobiliary Surgery and Liver Transplantation, Centre Hospitalier Universitaire de Montpellier, Montpellier, France 6. Department of Digestive Surgery and Liver Transplantation, Hôpital Huriez, Centre Hospitalier Universitaire de Lille, Université Nord de France, Lille, France 7. Department of Digestive Surgery, Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France 8. Department of Digestive Surgery, Hôpitaux Universitaires de Strasbourg, Strasbourg, France 9. Department of Hepatobiliary Surgery and Liver Transplantation, Hôpital Paul Brousse, Assistance Publique-Hopitaux de Paris and Université Paris XI, Paris, France
Abstract
Abstract
Background
The relevance of laparoscopic resection of intrahepatic cholangiocarcinoma (ICC) remains debated. The aim of this study was to compare laparoscopic (LLR) and open (OLR) liver resection for ICC, with specific focus on textbook outcome and lymph node dissection (LND).
Methods
Patients undergoing LLR or OLR for ICC were included from two French, nationwide hepatopancreatobiliary surveys undertaken between 2000 and 2017. Patients with negative margins, and without transfusion, severe complications, prolonged hospital stay, readmission or death were considered to have a textbook outcome. Patients who achieved both a textbook outcome and LND were deemed to have an adjusted textbook outcome. OLR and LLR were compared after propensity score matching.
Results
In total, 548 patients with ICC (127 LLR, 421 OLR) were included. Textbook-outcome and LND completion rates were 22.1 and 48.2 per cent respectively. LLR was independently associated with a decreased rate of LND (odds ratio 0.37, 95 per cent c.i. 0.20 to 0.69). After matching, 109 patients remained in each group. LLR was associated with a decreased rate of transfusion (7.3 versus 21.1 per cent; P = 0.001) and shorter hospital stay (median 7 versus 14 days; P = 0.001), but lower rate of LND (33.9 versus 73.4 per cent; P = 0.001). Patients who underwent LLR had lower rate of adjusted TO completion than patients who had OLR (6.5 versus 17.4 per cent; P = 0.012).
Conclusion
The laparoscopic approach did not substantially improve quality of care of patients with resectable ICC.
Publisher
Oxford University Press (OUP)
Cited by
35 articles.
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