Skip to main content
Top
Published in: Surgical Endoscopy 11/2016

01-11-2016

Comparison of perioperative and oncologic outcomes between open and laparoscopic liver resection for intrahepatic cholangiocarcinoma

Authors: Woohyung Lee, Ji-Ho Park, Ju-Yeon Kim, Seung-Jin Kwag, Taejin Park, Sang-Ho Jeong, Young-Tae Ju, Eun-Jung Jung, Young-Joon Lee, Soon-Chan Hong, Sang-Kyung Choi, Chi-Young Jeong

Published in: Surgical Endoscopy | Issue 11/2016

Login to get access

Abstract

Background

Laparoscopic liver resection (LLR) has become an essential method for treating malignant liver tumors. Although the perioperative and oncologic outcomes of LLR in patients with hepatocellular carcinoma have been reported, there are few reports of LLR for intrahepatic cholangiocarcinoma (IHCC).

Methods

Patients who underwent liver resection for T1 or T2 IHCC between March 2010 and March 2015 in Gyeongsang National University Hospital were enrolled. They were divided into open (n = 23) and laparoscopic (n = 14) approaches, and the perioperative and oncologic outcomes were compared.

Results

The Pringle maneuver was less frequently used (p = 0.015) and estimated blood loss was lesser (p = 0.006) in the laparoscopic group. There were no significant differences in complication rate (p = 1.000), hospital stay (p = 0.371), tumor size (p = 0.159), lymph node metastasis (p = 0.127), and the number of retrieved lymph nodes (p = 0.553). The patients were followed up for a median of 21 months. The 3-year overall survival (OS) and recurrence-free survival (RFS) rates were 74.7 and 55.2 %, respectively. No differences were observed in the 3-year OS (75.7 vs 84.6 %, p = 0.672) and RFS (56.7 vs 76.9 %, p = 0.456) rates between the open and laparoscopic groups, even after the groups were divided into patients that received liver resection with or without lymph node dissection.

Conclusion

LLR for IHCC is a treatment modality that should be considered as an option alongside open liver resection in selected patients.
Literature
2.
go back to reference Buell JF, Cherqui D, Geller DA, O’Rourke N, Iannitti D, Dagher I, Koffron AJ, Thomas M, Gayet B, Han HS, Wakabayashi G, Belli G, Kaneko H, Ker C-G, Scatton O, Laurent A, Abdalla EK, Chaudhury P, Dutson E, Gamblin C, D’Angelica M, Nagorney D, Testa G, Labow D, Manas D, Poon RT, Nelson H, Martin R, Clary B, Pinson WC, Martinie J, Vauthey J-N, Goldstein R, Roayaie S, Barlet D, Espat J, Abecassis M, Rees M, Fong Y, McMasters KM, Broelsch C, Busuttil R, Belghiti J, Strasberg S, Chari RS (2009) The international position on laparoscopic liver surgery. Ann Surg 250(5):825–830. doi:10.1097/SLA.0b013e3181b3b2d8 CrossRefPubMed Buell JF, Cherqui D, Geller DA, O’Rourke N, Iannitti D, Dagher I, Koffron AJ, Thomas M, Gayet B, Han HS, Wakabayashi G, Belli G, Kaneko H, Ker C-G, Scatton O, Laurent A, Abdalla EK, Chaudhury P, Dutson E, Gamblin C, D’Angelica M, Nagorney D, Testa G, Labow D, Manas D, Poon RT, Nelson H, Martin R, Clary B, Pinson WC, Martinie J, Vauthey J-N, Goldstein R, Roayaie S, Barlet D, Espat J, Abecassis M, Rees M, Fong Y, McMasters KM, Broelsch C, Busuttil R, Belghiti J, Strasberg S, Chari RS (2009) The international position on laparoscopic liver surgery. Ann Surg 250(5):825–830. doi:10.​1097/​SLA.​0b013e3181b3b2d8​ CrossRefPubMed
3.
go back to reference Wakabayashi G, Cherqui D, Geller DA, Buell JF, Kaneko H, Han HS, Asbun H, O’Rourke N, Tanabe M, Koffron AJ, Tsung A, Soubrane O, Machado MA, Gayet B, Troisi RI, Pessaux P, Van Dam RM, Scatton O, Abu Hilal M, Belli G, Kwon CH, Edwin B, Choi GH, Aldrighetti LA, Cai X, Cleary S, Chen KH, Schon MR, Sugioka A, Tang CN, Herman P, Pekolj J, Chen XP, Dagher I, Jarnagin W, Yamamoto M, Strong R, Jagannath P, Lo CM, Clavien PA, Kokudo N, Barkun J, Strasberg SM (2015) Recommendations for laparoscopic liver resection: a report from the second international consensus conference held in Morioka. Ann Surg 261(4):619–629. doi:10.1097/SLA.0000000000001180 PubMed Wakabayashi G, Cherqui D, Geller DA, Buell JF, Kaneko H, Han HS, Asbun H, O’Rourke N, Tanabe M, Koffron AJ, Tsung A, Soubrane O, Machado MA, Gayet B, Troisi RI, Pessaux P, Van Dam RM, Scatton O, Abu Hilal M, Belli G, Kwon CH, Edwin B, Choi GH, Aldrighetti LA, Cai X, Cleary S, Chen KH, Schon MR, Sugioka A, Tang CN, Herman P, Pekolj J, Chen XP, Dagher I, Jarnagin W, Yamamoto M, Strong R, Jagannath P, Lo CM, Clavien PA, Kokudo N, Barkun J, Strasberg SM (2015) Recommendations for laparoscopic liver resection: a report from the second international consensus conference held in Morioka. Ann Surg 261(4):619–629. doi:10.​1097/​SLA.​0000000000001180​ PubMed
4.
go back to reference Abu Hilal M, Badran A, Di Fabio F, Pearce NW (2011) Pure laparoscopic en bloc left hemihepatectomy and caudate lobe resection in patients with intrahepatic cholangiocarcinoma. J Laparoendosc Adv Surg Tech A 21(9):845–849. doi:10.1089/lap.2011.0247 CrossRefPubMed Abu Hilal M, Badran A, Di Fabio F, Pearce NW (2011) Pure laparoscopic en bloc left hemihepatectomy and caudate lobe resection in patients with intrahepatic cholangiocarcinoma. J Laparoendosc Adv Surg Tech A 21(9):845–849. doi:10.​1089/​lap.​2011.​0247 CrossRefPubMed
8.
9.
go back to reference Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, de Santibanes E, Pekolj J, Slankamenac K, Bassi C, Graf R, Vonlanthen R, Padbury R, Cameron JL, Makuuchi M (2009) The Clavien–Dindo classification of surgical complications: five-year experience. Ann Surg 250(2):187–196. doi:10.1097/SLA.0b013e3181b13ca2 CrossRefPubMed Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, de Santibanes E, Pekolj J, Slankamenac K, Bassi C, Graf R, Vonlanthen R, Padbury R, Cameron JL, Makuuchi M (2009) The Clavien–Dindo classification of surgical complications: five-year experience. Ann Surg 250(2):187–196. doi:10.​1097/​SLA.​0b013e3181b13ca2​ CrossRefPubMed
13.
go back to reference Takahashi M, Wakabayashi G, Nitta H, Takeda D, Hasegawa Y, Takahara T, Ito N (2013) Pure laparoscopic right hepatectomy by anterior approach with hanging maneuver for large intrahepatic cholangiocarcinoma. Surg Endosc 27(12):4732–4733. doi:10.1007/s00464-013-3202-2 CrossRefPubMed Takahashi M, Wakabayashi G, Nitta H, Takeda D, Hasegawa Y, Takahara T, Ito N (2013) Pure laparoscopic right hepatectomy by anterior approach with hanging maneuver for large intrahepatic cholangiocarcinoma. Surg Endosc 27(12):4732–4733. doi:10.​1007/​s00464-013-3202-2 CrossRefPubMed
14.
go back to reference Choi SB, Kim KS, Choi JY, Park SW, Choi JS, Lee WJ, Chung JB (2009) The prognosis and survival outcome of intrahepatic cholangiocarcinoma following surgical resection: association of lymph node metastasis and lymph node dissection with survival. Ann Surg Oncol 16(11):3048–3056. doi:10.1245/s10434-009-0631-1 CrossRefPubMed Choi SB, Kim KS, Choi JY, Park SW, Choi JS, Lee WJ, Chung JB (2009) The prognosis and survival outcome of intrahepatic cholangiocarcinoma following surgical resection: association of lymph node metastasis and lymph node dissection with survival. Ann Surg Oncol 16(11):3048–3056. doi:10.​1245/​s10434-009-0631-1 CrossRefPubMed
15.
go back to reference de Jong MC, Nathan H, Sotiropoulos GC, Paul A, Alexandrescu S, Marques H, Pulitano C, Barroso E, Clary BM, Aldrighetti L, Ferrone CR, Zhu AX, Bauer TW, Walters DM, Gamblin TC, Nguyen KT, Turley R, Popescu I, Hubert C, Meyer S, Schulick RD, Choti MA, Gigot JF, Mentha G, Pawlik TM (2011) Intrahepatic cholangiocarcinoma: an international multi-institutional analysis of prognostic factors and lymph node assessment. J Clin Oncol 29(23):3140–3145. doi:10.1200/JCO.2011.35.6519 CrossRefPubMed de Jong MC, Nathan H, Sotiropoulos GC, Paul A, Alexandrescu S, Marques H, Pulitano C, Barroso E, Clary BM, Aldrighetti L, Ferrone CR, Zhu AX, Bauer TW, Walters DM, Gamblin TC, Nguyen KT, Turley R, Popescu I, Hubert C, Meyer S, Schulick RD, Choti MA, Gigot JF, Mentha G, Pawlik TM (2011) Intrahepatic cholangiocarcinoma: an international multi-institutional analysis of prognostic factors and lymph node assessment. J Clin Oncol 29(23):3140–3145. doi:10.​1200/​JCO.​2011.​35.​6519 CrossRefPubMed
16.
go back to reference Kawarada Y, Yamagiwa K, Das BC (2002) Analysis of the relationships between clinicopathologic factors and survival time in intrahepatic cholangiocarcinoma. Am J Surg 183(6):679–685CrossRefPubMed Kawarada Y, Yamagiwa K, Das BC (2002) Analysis of the relationships between clinicopathologic factors and survival time in intrahepatic cholangiocarcinoma. Am J Surg 183(6):679–685CrossRefPubMed
18.
go back to reference Kim DH, Choi DW, Choi SH, Heo JS, Kow AW (2015) Is there a role for systematic hepatic pedicle lymphadenectomy in intrahepatic cholangiocarcinoma? A review of 17 years of experience in a tertiary institution. Surgery 157(4):666–675. doi:10.1016/j.surg.2014.11.006 CrossRefPubMed Kim DH, Choi DW, Choi SH, Heo JS, Kow AW (2015) Is there a role for systematic hepatic pedicle lymphadenectomy in intrahepatic cholangiocarcinoma? A review of 17 years of experience in a tertiary institution. Surgery 157(4):666–675. doi:10.​1016/​j.​surg.​2014.​11.​006 CrossRefPubMed
Metadata
Title
Comparison of perioperative and oncologic outcomes between open and laparoscopic liver resection for intrahepatic cholangiocarcinoma
Authors
Woohyung Lee
Ji-Ho Park
Ju-Yeon Kim
Seung-Jin Kwag
Taejin Park
Sang-Ho Jeong
Young-Tae Ju
Eun-Jung Jung
Young-Joon Lee
Soon-Chan Hong
Sang-Kyung Choi
Chi-Young Jeong
Publication date
01-11-2016
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 11/2016
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-016-4817-x

Other articles of this Issue 11/2016

Surgical Endoscopy 11/2016 Go to the issue