So Hyun Kang, Woohyung Lee, Youngrok Choi, Ho-Seong Han, Yoo-Seok Yoon, Jai Young Cho, Kilhwan Kim, In-Gun Hyun, Sunjong Han. Seoul National University Bundang Hospital
Introduction: Laparoscopic liver resection (LLR) for intrahepatic cholangiocarcinoma is debatable due to technical challenges associated with major hepatectomy and lymph node dissection. Published studies regarding this issue is scarce due to the rarity of the disease. This study aims to analyze the long-term survival, postoperative complications, and covariates that influence both outcomes.
Methods: Patients who underwent liver resection for intrahepatic cholangiocarcinoma from August 2004 to June 2015 were enrolled. Those who had combined hepatocellular carcinoma, palliative surgery, and conversion to open procedure were excluded. Medical records of these patients were reviewed for postoperative outcome, recurrence, and survival. The 3-year disease-free survival (DFS) and 3-year overall survival (OS) were set as the primary endpoint, and 3-year disease-specific survival, 1-year OS, 1-year DFS, operative outcome, and postoperative complications were secondary endpoints. Kaplan-Meier survival analysis was performed, and the Cox regression model was done for associated factors.
Results: A total of 53 patients were enrolled with 33 in the open group and 20 in the laparoscopic group. There was no difference in age, gender, tumor location, and liver status. The 3-year OS was 69.7% in the open group and 70.0% in the laparoscopic group(p=0.929). For 3-year DFS, open was 53.1% and laparoscopic was 66.7% (p=0.391). The 3-year disease-specific survival was 78.8% for the open group and 70.0% for the laparoscopic group (p=0.573). Mean operation time for the open group was 347.4 ± 95.7 minutes and laparoscopic group was 375.8 ± 219.0 minutes (p=0.589). Tumor size and liver state was associated with less 3-year DFS (p value <0.001 and 0.008 respectively). Postoperative complication of Clavien-Dindo grade II or more was 9(27.3%) in the open group and 5(25.0%) in the laparoscopic group (p=0.978). Hospital stay was significantly shorter in the laparoscopic group (10.1 ± 5.9 days) than the open group (17.4 ± 13.8, p=0.021).
Conclusion: Laparoscopic liver resection for intrahepatic cholangiocarcinoma is technically feasible and safe, providing short-term benefits without increasing complications or affecting disease-free survival.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94093
Program Number: S015
Presentation Session: HPB
Presentation Type: Podium
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