Laparoscopic versus open surgery for perihilar cholangiocarcinoma: a multicenter propensity score analysis of short- term outcomes

作者全名："Wang, Min; Qin, Tingting; 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; Liu, Jun; Liu, Jianhua; Yin, Xinmin; Qin, Renyi"

作者地址："[Wang, Min; Qin, Tingting; Zhang, Hang; Feng, Yechen; Qin, Renyi] Huazhong Univ Sci & Technol, Affiliated Tongji Hosp, Tongji Med Coll, Dept Biliary Pancreat Surg, Wuhan 430030, Hubei, Peoples R China; [Li, Jingdong; Xu, Jian] North Sichuan Med Coll, Affiliated Hosp, North Sichuan Med Coll, Hepatobiliary Pancreat & Intestinal Dis Res Inst,D, Nanchong 637000, Peoples R China; [Deng, Xiaxing; Xie, Junjie] Shanghai Jiao Tong Univ, Dept Ruijin Hosp, Sch Med, Shanghai 310000, Peoples R China; [Zhang, Yuhua; Dou, Changwei] Hangzhou Med Coll, Zhejiang Prov Peoples Hosp, Peoples Hosp, Dept Hepatobiliary Pancreat & Minimal Invas Surg, Hangzhou 310003, Peoples R China; [Zhao, Wenxing; Ma, Hongqin] Xuzhou Med Univ, Affiliated Hosp, Dept Gen Surg, Xuzhou 221000, Jiangsu, Peoples R China; [Fan, Ying; Liu, Gangshan] China Med Univ, Sheng Jing Hosp, Dept Gen Surg 2, Shenyang 110000, Liaoning, Peoples R China; [Li, Dewei; Shao, Yue] Chongqing Med Univ, Affiliated Hosp 1, Dept Hepatobiliary Surg, Chongqing 400016, Peoples R China; [Chen, Xuemin; Chen, Weibo] Soochow Univ, Affiliated Hosp 3, Dept Hepatopancreatobiliary Surg, Suzhou 213003, Peoples R China; [Zhu, Siwei; Yin, Xinmin] Hunan Normal Univ, Hunan Prov Peoples Hosp, Affiliated Hosp 1, Dept Hepatobiliary Surg, Changsha 410005, Hunan, Peoples R China; [Xing, Zhongqiang; Liu, Jianhua] Hebei Med Univ, Hosp 2, Dept Hepatopancreato Biliary Surg, Shijiazhuang 050017, Hebei, Peoples R China; [Yu, Guangsheng; Liu, Jun] Shandong Acad Med Sci, Shandong Prov Inst Dermatol & Venereol, 27397 Jingshi Rd, Jinan 250022, Peoples R China"

通信作者："Qin, RY (通讯作者)，Huazhong Univ Sci & Technol, Affiliated Tongji Hosp, Tongji Med Coll, Dept Biliary Pancreat Surg, Wuhan 430030, Hubei, Peoples R China.; Yin, XM (通讯作者)，Hunan Normal Univ, Hunan Prov Peoples Hosp, Affiliated Hosp 1, Dept Hepatobiliary Surg, Changsha 410005, Hunan, Peoples R China.; Liu, JH (通讯作者)，Hebei Med Univ, Hosp 2, Dept Hepatopancreato Biliary Surg, Shijiazhuang 050017, Hebei, Peoples R China.; Liu, J (通讯作者)，Shandong Acad Med Sci, Shandong Prov Inst Dermatol & Venereol, 27397 Jingshi Rd, Jinan 250022, Peoples R China."

来源：BMC CANCER

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000979896100001

JCR分区：Q2

影响因子：3.4

年份：2023

卷号：23

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Perihilar cholangiocarcinoma; Laparoscopic; Open resection; Short-term outcomes

摘要："BackgroundLaparoscopic surgery (LS) has been increasingly applied in perihilar cholangiocarcinoma (pCCA). In this study, we intend to compare the short-term outcomes of LS versus open operation (OP) for pCCA in a multicentric practice in China.MethodsThis real-world analysis included 645 pCCA patients receiving LS and OP at 11 participating centers in China between January 2013 and January 2019. A comparative analysis was performed before and after propensity score matching (PSM) in LS and OP groups, and within Bismuth subgroups. Univariate and multivariate models were performed to identify significant prognostic factors of adverse surgical outcomes and postoperative length of stay (LOS).ResultsAmong 645 pCCAs, 256 received LS and 389 received OP. Reduced hepaticojejunostomy (30.89% vs 51.40%, P = 0.006), biliary plasty requirement (19.51% vs 40.16%, P = 0.001), shorter LOS (mean 14.32 vs 17.95 d, P < 0.001), and lower severe complication (CD >= III) (12.11% vs. 22.88%, P = 0.006) were observed in the LS group compared with the OP group. Major postoperative complications such as hemorrhage, biliary fistula, abdominal abscess, and hepatic insufficiency were similar between LS and OP (P > 0.05 for all). After PSM, the short-term outcomes of two surgical methods were similar, except for shorter LOS in LS compared with OP (mean 15.19 vs 18.48 d, P = 0.0007). A series subgroup analysis demonstrated that LS was safe and had advantages in shorting LOS.ConclusionAlthough the complex surgical procedures, LS generally seems to be safe and feasible for experienced surgeons."

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