BMC Cancer (May 2023)

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

DOI
https://doi.org/10.1186/s12885-023-10783-9
Journal volume & issue
Vol. 23, no. 1
pp. 1 – 16

Abstract

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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).

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