A Consensus Meeting on Expert Recommendations on Operating Specifications for Laparoscopic Radical Resection of Hilar Cholangiocarcinoma

Xiong, Yong; Li, Jingdong; Tang, Zhaohui; Lau, Joseph W.Y.

doi:10.3389/fsurg.2021.731448

Cited by 4 publications

(2 citation statements)

References 33 publications

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“…In fact, successful laparoscopic radical resection of HCCA requires excellent surgical skills and rich experience. With the improvements in minimally-invasive surgical instruments, surgical skills, and accumulation of surgical experience, more patients have undergone laparoscopic or robotic radical resection of HCCA (5)(6)(7)(8)(9)(10)(11). Herein we retrospectively analyzed the clinical data of the patients who underwent radical surgery for HCCA in our center, and compared the efficacy of laparoscopic and open surgery for the patients with HCCA.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Efficacy and Safety Between Laparoscopic and Open Radical Resection for Hilar Cholangiocarcinoma—A Propensity Score-Matching Analysis

Huang

Ren

et al. 2022

Front. Oncol.

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BackgroundRadical resection remains the most effective treatment for hilar cholangiocarcinoma (HCCA). However, due to the complex anatomy of the hilar region, the tumor is prone to invade portal vein and hepatic arteries, making the surgical treatment of HCCA particularly difficult. Successful laparoscopic radical resection of HCCA(IIIA, IIIB) requires excellent surgical skills and rich experience. Furthermore, the safety and effectiveness of this operation are still controversial.AimTo retrospectively analyze and compare the efficacy and safety of laparoscopic and open surgery for patients with HCCA.MethodsClinical imaging and postoperative pathological data of 89 patients diagnosed with HCCA (IIIA, IIIB) and undergoing radical resection in our center from January 2018 to March 2022 were retrospectively analyzed. Among them, 6 patients (4 were lost to follow-up and 2 were pathologically confirmed to have other diseases after surgery) were ruled out, and clinical data was collected from the remaining 83 patients for statistical analysis. These patients were divided into an open surgery group (n=62) and a laparoscopic surgery group (n=21) according to the surgical methods used, and after 1:2 propensity score matching (PSM), 32 and 16 patients respectively in the open surgery group and laparoscopic surgery group were remained. The demographic data, Bismuth type, perioperative data, intraoperative data, postoperative complications, pathological findings, and long-term survivals were compared between these two groups.ResultsAfter 1:2 PSM, 32 patients in the open surgery group and 16 patients in the laparoscopic surgery group were included for further analysis. Baseline characteristics and pathological outcomes were comparable between the two groups. Statistically significant differences between the two groups were observed in intraoperative blood loss and operative time, as it were 400-800 mL vs 200-400 mL (P=0.012) and (407.97 ± 76.06) min vs (489.69 ± 79.17) min (P=0.001) in the open surgery group and laparoscopic surgery group, respectively. The R0 resection rate of the open group was 28 cases (87.5%), and the R0 resection rate of the laparoscopic group was 15 cases (93.75%). The two groups showed no significant difference in terms of surgical approach, intraoperative blood transfusion, incidence of postoperative complications, and short- and long-term efficacy (P>0.05).ConclusionsLaparoscopic radical resection of HCCA has comparable perioperative safety compared to open surgery group, as it has less bleeding and shorter operation time. Although it is a promising procedure with the improvement of surgical skills and further accumulation of experience, further investigations are warranted before its wider application.

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Section: Introductionmentioning

confidence: 99%

Comparison of Efficacy and Safety Between Laparoscopic and Open Radical Resection for Hilar Cholangiocarcinoma—A Propensity Score-Matching Analysis

Huang

Ren

et al. 2022

Front. Oncol.

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“…[ 10 ] Surgery is the main treatment for cholangiocarcinoma,[ 11 ] but it is very dangerous due to its proximity to the hepatic artery of the portal vein. [ 12 ]…”

Section: Introductionmentioning

confidence: 99%

Comparing the efficacy and complications of Endoscopic Biliary Drainage (EBD) and Percutaneous Transhepatic Biliary Drainage (PTBD) in patients with perihilar cholangiocarcinoma

Pirayvatlou

Roushan

et al. 2022

Journal of Family Medicine and Primary Care

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A BSTRACT Introduction and Objective: Hilar cholangiocarcinoma (HCCA) is a rare malignancy in patients with biliary disease. If jaundice and obstruction before surgery are left untreated, then they can cause side effects such as cholangitis, delayed tumor treatment, decreased quality of life, and increased mortality. Surgery is the main treatment for HCCA. Therefore, this study was performed to compare the efficacy and complications of percutaneous transhepatic biliary drainage (PTBD) and endoscopic biliary drainage (EBD). Methods: This cohort study was conducted on 20 patients with biliary obstruction who had been selected by simple random sampling and divided into two groups of EBD and PTBD. Three weeks after surgery, patients were compared in terms of bilirubin levels and postoperative complications. Data were analyzed by descriptive statistics (table, mean, and standard deviation) and inferential statistics (independent t-test, Chi-square test, and Fisher’s test). Results: Independent t -test did not show a significant difference between the two groups in terms of bilirubin level ( P = 0.77). However, despite a decrease in bilirubin level in both groups, independent t-test showed that this difference was not significant ( P = 0.08). Fisher’s exact test showed a significant difference between the two groups in terms of postoperative complications ( P = 0.02). Conclusion: Using both drainage methods before surgery reduced bilirubin levels in patients, but EBD method had fewer side effects than PTBD method. The EBD method was performed under the direct supervision of a gastroenterologist. In performing this procedure, specialist physicians should have more supervision.

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Total three-dimensional laparoscopic radical resection for Bismuth type IV hilar cholangiocarcinoma

Liu

Zhang

et al. 2023

Hepatobiliary & Pancreatic Diseases International

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A Consensus Meeting on Expert Recommendations on Operating Specifications for Laparoscopic Radical Resection of Hilar Cholangiocarcinoma

Cited by 4 publications

References 33 publications

Comparison of Efficacy and Safety Between Laparoscopic and Open Radical Resection for Hilar Cholangiocarcinoma—A Propensity Score-Matching Analysis

Comparison of Efficacy and Safety Between Laparoscopic and Open Radical Resection for Hilar Cholangiocarcinoma—A Propensity Score-Matching Analysis

Comparing the efficacy and complications of Endoscopic Biliary Drainage (EBD) and Percutaneous Transhepatic Biliary Drainage (PTBD) in patients with perihilar cholangiocarcinoma

Total three-dimensional laparoscopic radical resection for Bismuth type IV hilar cholangiocarcinoma

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