The Long-Term Outcome of Laparoscopic Resection for Perihilar Cholangiocarcinoma Compared with the Open Approach: A Real-World Multicentric Analysis

作者全名："Qin, Tingting; Wang, Min; Zhang, Hang; Li, Jingdong; Deng, Xiaxing; Zhang, Yuhua; Zhao, Wenxing; Fan, Ying; Li, Dewei; Chen, Xuemin; Feng, Yechen; Zhu, Siwei; Xing, Zhongqiang; Yu, Guangsheng; Xu, Jian; Xie, Junjie; Dou, Changwei; Ma, Hongqin; Liu, Gangshan; Shao, Yue; Chen, Weibo; Xu, Simiao; Liu, Jun; Liu, Jianhua; Yin, Xinmin; Qin, Renyi"

作者地址："[Qin, Tingting; Wang, Min; Zhang, Hang; Feng, Yechen; Qin, Renyi] Huazhong Univ Sci & Technol, Affiliated Tongji Hosp, Tongji Med Coll, Dept Biliary Pancreat Surg, Wuhan, Hubei, Peoples R China; [Li, Jingdong; Xu, Jian] North Sichuan Med Coll, Hepatobiliary Pancreat & Intestinal Dis Res Inst, Dept Hepatobiliary Surg, Affiliated Hosp, Nanchong, Peoples R China; [Deng, Xiaxing; Xie, Junjie] Shanghai Jiao Tong Univ, Ruijin Hosp, Sch Med, Shanghai, Peoples R China; [Zhang, Yuhua; Dou, Changwei] Zhejiang Prov Peoples Hosp, Peoples Hosp, Dept Hepatobiliary Pancreat & Minimal Invas Surg, Hangzhou Med Coll, Hangzhou, Peoples R China; [Zhao, Wenxing; Ma, Hongqin] Xuzhou Med Univ, Dept Gen Surg, Affiliated Hosp, Xuzhou, Jiangsu, Peoples R China; [Fan, Ying; Liu, Gangshan] China Med Univ, Dept Gen Surg 2, Sheng Jing Hosp, Shenyang, Liaoning, Peoples R China; [Li, Dewei; Shao, Yue] Chongqing Med Univ, Dept Hepatobiliary Surg, Affiliated Hosp 1, Chongqing, Peoples R China; [Chen, Xuemin; Chen, Weibo] Soochow Univ, Dept Hepatopancreatobiliary Surg, Affiliated Hosp 3, Suzhou, Peoples R China; [Zhu, Siwei; Yin, Xinmin] Hunan Normal Univ, Hunan Prov Peoples Hosp, Dept Hepatobiliary Surg, Affiliated Hosp 1, Changsha, Hunan, Peoples R China; [Xing, Zhongqiang; Liu, Jianhua] Hebei Med Univ, Dept Hepatopancreatobiliary Surg, Hosp 2, Shijiazhuang, Hebei, Peoples R China; [Yu, Guangsheng; Liu, Jun] Shandong Univ, Shandong Acad Med Sci, Shandong Prov Inst Dermatol & Venereol, Shandong Prov Hosp, Jinan, Shandong, Peoples R China; [Xu, Simiao] Huazhong Univ Sci & Technol, Affiliated Tongji Hosp, Tongji Med Coll, Dept Endocrinol, Wuhan, Peoples R China"

通信作者："Liu, J (通讯作者)，Shandong Univ, Shandong Acad Med Sci, Shandong Prov Inst Dermatol & Venereol, Shandong Prov Hosp, Jinan, Shandong, Peoples R China."

来源：ANNALS OF SURGICAL ONCOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000871175800005

JCR分区：Q1

影响因子：3.7

年份：2022

卷号：　

期号：　

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结束页：　

文献类型：Article; Early Access

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摘要："Objective The aim of this study was to compare the short- and long-term outcomes of laparoscopic surgery (LS) and open surgery (OP) for perihilar cholangiocarcinoma (PHC) using a large real-world dataset in China. Methods Data of patients with PHC who underwent LS and OP from January 2013 to October 2018, across 10 centers in China, were extracted from medical records. A comparative analysis was performed before and after propensity score matching (PSM) in the LS and OP groups and within the study subgroups. The Cox proportional hazards mixed-effects model was applied to estimate the risk factors for mortality, with center and year of operation as random effects. Results A total of 467 patients with PHC were included, of whom 161 underwent LS and 306 underwent OP. Postoperative morbidity, such as hemorrhage, biliary fistula, abdominal abscess, and hepatic insufficiency, was similar between the LS and OP groups. The median overall survival (OS) was longer in the LS group than in the OP group (NA vs. 22 months; hazard ratio [HR] 1.19, 95% confidence interval [CI] 1.02-1.39, p = 0.024). Among the matched datasets, OS was comparable between the LS and OP groups (NA vs. 35 months; HR 0.99, 95% CI 0.77-1.26, p = 0.915). The mixed-effect model identified that the surgical method was not associated with long-term outcomes and that LS and OP provided similar oncological outcomes. Conclusions Considering the comparable long-term prognosis and short-term outcomes of LS and OP, LS could be a technically feasible surgical method for PHC patients with all Bismuth-Corlett types of PHC."

基金机构："National Natural Science Foundation of China [81772950, 81773160, 81702792]; Hubei Natural Science Foundation [2017CFB467, 2019CR203]; Tongji Hospital Science Fund for Distinguished Young Scholars; National Key Research and Development Program of China [2019YFC1315905]"

基金资助正文："This work was supported by grants from the National Natural Science Foundation of China (81772950 to RYQ, 81773160 to MW, 81702792 to SMX), Hubei Natural Science Foundation (2017CFB467) to MW, Tongji Hospital Clinical Research Flagship Program (2019CR203) to RYQ, and Tongji Hospital Science Fund for Distinguished Young Scholars (2017) to MW, as well as the National Key Research and Development Program of China (2019YFC1315905). The authors are thankful for all the support from grants, and thank all patients and co-investigators at each of the participating centers for collecting and providing the study information. They would also like to thank Editage (www.editage.com) for medical English language editing."