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Minimally invasive surgery for hilar cholangiocarcinoma: a multicenter retrospective analysis of 158 patients.

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机构: [1]Department of General Surgery, Institute of Hepatobiliary- Pancreatic-Intestinal Diseases, Affiliated Hospital of North Sichuan Medical College, No.63 Wenhua Road, Shunqing District, Nanchong 637000, China [2]Department of Hepatobiliary Surgery, Second Affiliated Hospital of Hebei Medical University, Hebei 200092, China [3]Department of Hepatobiliary Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221006, China [4]Department of Biliary Pancreatic Surgery, Affiliated Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China [5]Department of Hepatobiliary Surgery, Hunan Provincial People’s Hospital, Changsha 410005, China [6]Department of Biliary Surgery, The First Hospital Affiliated to Army Medical University, Chongqing 400038, China [7]Department of Hepatobiliary Surgery, SirRunRunShaw Hospital of Zhejiang University, Hangzhou 310020, China [8]Department of Biliary Surgery, West China Hospital of Sichuan University, Chengdu 610041, China [9]Department of Hepatobiliary Surgery, Nanfang Hospital of Southern Medical University, Guangzhou 510515, China [10]Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China [11]Department of General Surgery, Xinhua Hospital Affiliated of Shanghai Jiaotong University School of Medicine, Yangpu District, No.1665 Kong jiang Road, Shanghai 200000, China
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关键词: Hilar cholangiocarcinoma Minimally invasive surgery Multicenter clinical study

摘要:
Curative resection of hilar cholangiocarcinoma (HC) is typically carried out using open surgery. In the present study, we examined the safety (postoperative complication) and effectiveness (resection margin status and patient survival) of minimally invasive surgery (MIS) for HC. This retrospective analysis included 158 patients receiving MIS for HC at 10 participating centers between December 2013 and November 2019. Patient demographics, surgical outcomes, and oncological outcomes were retrospectively analyzed. Clinical information obtained from 10 different clinical centers did not show any evident cohort-bias clustering. One hundred and twenty-six (79.7%) patients underwent LRHC, 12 (7.6%) patients underwent RARHC, conversion to an open procedure occurred in 20 (12.7%) patients. The operation time and estimated blood loss were 410.8 ± 128.9 min and 477.8 ± 706.3 mL, respectively. The surgical radicality of the 158 patients was R0, 129 (81.6%); R1, 20 (18.4%) and R2, 9 (5.7%). Grades I-II complications was occurred in 68 (43.0%) patients. Severe morbidity (grade III-V) occurred in 14 (8.7%) patients. The median overall survival in whole cohort was 25.4 months. The overall survival rate was 67.6% at year 1, 28.8% at year 3, and 19.2% at year 5. Comparing the first half of MISHC performed by each center with the following cases, the operation time and postoperative hospital stay does not decrease with the increasing cases. On literature review, MISHC is non-inferior to open surgery at least in perioperative period. In this Chinese MIS for HC multicenter study, the largest to date, long-term overall survival rates after MIS appear comparable to those reported in current open series. Further randomized controlled trials are necessary to assess the global impact of MISHC.

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大类 | 2 区 医学
小类 | 2 区 外科
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大类 | 2 区 医学
小类 | 2 区 外科
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Q2 SURGERY
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Q2 SURGERY

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第一作者机构: [1]Department of General Surgery, Institute of Hepatobiliary- Pancreatic-Intestinal Diseases, Affiliated Hospital of North Sichuan Medical College, No.63 Wenhua Road, Shunqing District, Nanchong 637000, China
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