Laparoscopic versus open surgery for perihilar cholangiocarcinoma: a multicenter propensity score analysis of short- term outcomes
Min Wang,
Tingting Qin,
Hang Zhang,
Jingdong Li,
Xiaxing Deng,
Yuhua Zhang,
Wenxing Zhao,
Ying Fan,
Dewei Li,
Xuemin Chen,
Yechen Feng,
Siwei Zhu,
Zhongqiang Xing,
Guangsheng Yu,
Jian Xu,
Junjie Xie,
Changwei Dou,
Hongqin Ma,
Gangshan Liu,
Yue Shao,
Weibo Chen,
Jun Liu,
Jianhua Liu,
Xinmin Yin,
Renyi Qin
Affiliations
Min Wang
Department of Biliary–Pancreatic Surgery, Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
Tingting Qin
Department of Biliary–Pancreatic Surgery, Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
Hang Zhang
Department of Biliary–Pancreatic Surgery, Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
Jingdong Li
Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical College, Hepatobiliary, Pancreatic and Intestinal Diseases Research Institute of North Sichuan Medical College
Xiaxing Deng
Department of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
Yuhua Zhang
Department of Hepatobiliary, Pancreatic and Minimal Invasive Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College
Wenxing Zhao
Department of General Surgery, the Affiliated Hospital of Xuzhou Medical University Xuzhou
Ying Fan
Department of the Second General Surgery, Sheng Jing Hospital of China Medical University
Dewei Li
Department of Hepatobiliary Surgery, the First Affiliated Hospital of Chongqing Medical University
Xuemin Chen
Department of Hepatopancreatobiliary Surgery, Third Affiliated Hospital of Soochow University
Yechen Feng
Department of Biliary–Pancreatic Surgery, Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
Siwei Zhu
Department of Hepatobiliary Surgery, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University
Zhongqiang Xing
Department of Hepato-Pancreato-Biliary Surgery, the Second Hospital of Hebei Medical University
Guangsheng Yu
Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences
Jian Xu
Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical College, Hepatobiliary, Pancreatic and Intestinal Diseases Research Institute of North Sichuan Medical College
Junjie Xie
Department of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
Changwei Dou
Department of Hepatobiliary, Pancreatic and Minimal Invasive Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College
Hongqin Ma
Department of General Surgery, the Affiliated Hospital of Xuzhou Medical University Xuzhou
Gangshan Liu
Department of the Second General Surgery, Sheng Jing Hospital of China Medical University
Yue Shao
Department of Hepatobiliary Surgery, the First Affiliated Hospital of Chongqing Medical University
Weibo Chen
Department of Hepatopancreatobiliary Surgery, Third Affiliated Hospital of Soochow University
Jun Liu
Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences
Jianhua Liu
Department of Hepato-Pancreato-Biliary Surgery, the Second Hospital of Hebei Medical University
Xinmin Yin
Department of Hepatobiliary Surgery, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University
Renyi Qin
Department of Biliary–Pancreatic Surgery, Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
Abstract Background Laparoscopic 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. Methods This 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). Results Among 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 0.05 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. Conclusion Although the complex surgical procedures, LS generally seems to be safe and feasible for experienced surgeons. Trial registration NCT05402618 (date of first registration: 02/06/2022).
