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Surgical Endoscopy

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01-09-2017

Can laparoscopic liver resection provide a favorable option for patients with large or multiple intrahepatic cholangiocarcinomas?

Authors: Fangqiang Wei, Chen Lu, Liuxin Cai, Hong Yu, Xiao Liang, Xiujun Cai

Published in: Surgical Endoscopy | Issue 9/2017

Abstract

Background

The role of laparoscopic liver resection (LLR) for large or multiple intrahepatic cholangiocarcinomas (ICCs) remains equivocal. The main concerns are potential risks of inadequate resection margin, tumor rupture, uncontrollable bleeding, tumor seeding, and inadequate lymph node sampling. In this study, we aimed to determine the safety, feasibility, and oncological efficacy of LLR for large (≥5 cm) or multiple (≥2) ICCs.

Methods

Among 50 patients receiving liver resection for ICC between May 2004 and January 2016, 12 patients who had undergone LLR for large or multiple ICCs (Group A, n = 12) were compared with 18 patients who had undergone LLR for small solitary ICCs (Group B, n = 18), as well were compared with 20 patients who had undergone open liver resection for large or multiple ICCs (Group C, n = 20). Perioperative and long-term outcomes were analyzed.

Results

Compared with Group B, Group A had fewer patients with T1 tumors (58.3 vs. 100%; P = 0.006) and a longer hospital stay (14 vs. 9 days; P = 0.039); operating time, blood loss, surgical margin, cases receiving lymph node dissection, conversion rates, and morbidity were comparable. There were no life-threatening complications and no mortality. No tumor rupture or dissemination occurred, nor did port-site recurrence follow surgery. After a median follow-up of 22 months, no difference was noted in 3-year overall survival (56.3 vs. 59.5%; P > 0.05) and recurrence-free survival (43.8 vs. 50%; P > 0.05) between the two groups. Similarly, perioperative and long-term outcomes were comparable between Group A and Group C.

Conclusion

LLR for large or multiple ICCs is technically safe, feasible, and oncologically effective in select patients. It provides a favorable option for patients seeking curative treatment. The minimally invasive nature will benefit these patients without compromising the oncological efficacy. Future larger-scale studies and well-designed randomized trials are warranted to evaluate this issue.

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Title: Can laparoscopic liver resection provide a favorable option for patients with large or multiple intrahepatic cholangiocarcinomas?
Authors: Fangqiang Wei
Chen Lu
Liuxin Cai
Hong Yu
Xiao Liang
Xiujun Cai
Publication date: 01-09-2017
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 9/2017
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-016-5399-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Can laparoscopic liver resection provide a favorable option for patients with large or multiple intrahepatic cholangiocarcinomas?

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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