机构：[1]Department of Biliary–Pancreatic Surgery, Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China.华中科技大学同济医学院附属同济医院[2]Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical College, Hepatobiliary, Pancreatic and Intestinal Diseases Research Institute of North Sichuan Medical College, Nanchong 637000, China.[3]Department of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 310000, China.[4]Department of Hepatobiliary, Pancreatic and Minimal Invasive Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310003, China.[5]Department of General Surgery, the Affiliated Hospital of Xuzhou Medical University Xuzhou, Jiangsu 221000, China.[6]Department of the Second General Surgery, Sheng Jing Hospital of China Medical University, Liaoning 110000, China.中国医科大学附属盛京医院中国医科大学盛京医院[7]Department of Hepatobiliary Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China重庆医科大学附属第一医院[8]Department of Hepatopancreatobiliary Surgery, Third Affiliated Hospital of Soochow University, Suzhou 213003, China.[9]Department of Hepatobiliary Surgery, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha 410005, Hunan, China.[10]Department of Hepato‑Pancreato‑Biliary Surgery, the Second Hospital of Hebei Medical University, Shijiazhuang 050017, Hebei, China.[11]Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, 27397 Jingshi Road, Jinan 250022, China.
BackgroundLaparoscopic surgery (LS) has been increasingly applied in perihilar cholangiocarcinoma (pCCA). In this study, we intend to compare the short-term outcomes of LS versus open operation (OP) for pCCA in a multicentric practice in China.MethodsThis real-world analysis included 645 pCCA patients receiving LS and OP at 11 participating centers in China between January 2013 and January 2019. A comparative analysis was performed before and after propensity score matching (PSM) in LS and OP groups, and within Bismuth subgroups. Univariate and multivariate models were performed to identify significant prognostic factors of adverse surgical outcomes and postoperative length of stay (LOS).ResultsAmong 645 pCCAs, 256 received LS and 389 received OP. Reduced hepaticojejunostomy (30.89% vs 51.40%, P = 0.006), biliary plasty requirement (19.51% vs 40.16%, P = 0.001), shorter LOS (mean 14.32 vs 17.95 d, P < 0.001), and lower severe complication (CD >= III) (12.11% vs. 22.88%, P = 0.006) were observed in the LS group compared with the OP group. Major postoperative complications such as hemorrhage, biliary fistula, abdominal abscess, and hepatic insufficiency were similar between LS and OP (P > 0.05 for all). After PSM, the short-term outcomes of two surgical methods were similar, except for shorter LOS in LS compared with OP (mean 15.19 vs 18.48 d, P = 0.0007). A series subgroup analysis demonstrated that LS was safe and had advantages in shorting LOS.ConclusionAlthough the complex surgical procedures, LS generally seems to be safe and feasible for experienced surgeons.
基金：
This work was supported by grants from The National Natural Science Foundation
of China (81772950 to RY Q, 81773160 to MW, 81702792 to SM X), Natural
Science Foundation of Hubei Province (2017CFB467) to MW, Tongji Hospital
Clinical Research Flagship Program (2019CR203) to RY Q, and Tongji Hospital
Science Fund for Distinguished Young Scholars (2017) to MW, National Key
Research and Development Program of China (2019YFC1315905).
第一作者机构：[1]Department of Biliary–Pancreatic Surgery, Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China.
共同第一作者：
通讯作者：
推荐引用方式(GB/T 7714)：
Wang Min,Qin Tingting,Zhang Hang,et al.Laparoscopic versus open surgery for perihilar cholangiocarcinoma: a multicenter propensity score analysis of short- term outcomes[J].BMC CANCER.2023,23(1):doi:10.1186/s12885-023-10783-9.
APA：
Wang, Min,Qin, Tingting,Zhang, Hang,Li, Jingdong,Deng, Xiaxing...&Qin, Renyi.(2023).Laparoscopic versus open surgery for perihilar cholangiocarcinoma: a multicenter propensity score analysis of short- term outcomes.BMC CANCER,23,(1)
MLA：
Wang, Min,et al."Laparoscopic versus open surgery for perihilar cholangiocarcinoma: a multicenter propensity score analysis of short- term outcomes".BMC CANCER 23..1(2023)
医学