Following laparoscopic liver resection, patients with intrahepatic cholangiocarcinoma (ICC) demonstrated improved short-term postoperative outcomes and similar long-term oncological outcomes compared with open liver resection, according to study findings published in the Scandinavian Journal of Gastroenterology.
ICC is the second most common type of liver cancer. It is frequently diagnosed during an advanced stage due to late onset of symptoms.
Liver resection provides the only potential curative treatment for ICC with laparoscopic resection replacing open resection at specialized centers of expertise.
Researchers conducted a multicenter, retrospective, propensity score-matched study to compare surgical and oncological outcomes of 136 patients with ICC who underwent either laparoscopic or open liver resections between 2012 and 2019 across 4 European centers in Norway, Belgium, Russia, and Slovenia.
Of the 136 patients with ICC, 50 (36.7%) had laparoscopic liver resections, whereas the remaining 86 (63.3%) underwent open liver resections. Tumor characteristics were similar between the 2 groups.
Compared with open resections, researchers discovered that laparoscopic resections resulted in significantly fewer complications (30 % vs 52%, P =.025), fewer reoperations (4% vs 16%; P =.046), and decreased lengths of stay in the hospital (5 vs 8 days; P <.01).
In contrast, open resections were associated with increased operative times (294 vs 209 min; P <.01), lymphadenectomy (60% vs 20%; P <.01), and major liver resection (74% vs 38%; P <.01).
Oncological outcomes associated with recurrence, recurrence-free survival, and overall survival remained similar between surgical groups.
“Patients with resectable ICC may be considered for laparoscopic resection in expert centers with sufficient expertise, especially when lymphadenectomy is not paramount,” the study authors wrote.
Study limitations include the retrospective design, possible treatment selection bias based on the surgeon’s judgment given ICC location within the liver, missing data from the final dataset on recurrence and pathology-related parameters, and the relatively small sample size.
Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
Sahakyan MA, Aghayan DL, Edwin B, et al. Laparoscopic versus open liver resection for intrahepatic cholangiocarcinoma: a multicenter propensity score-matched study. Scand J Gastroenterol. Published online November 14, 2022:1-8. doi:10.1080/00365521.2022.2143724