Advertisement
Original article| Volume 25, ISSUE 3, P339-346, March 2023

Download started.

Ok

Laparoscopic versus open liver resections for intrahepatic cholangiocarcinoma and gallbladder cancer: the Mayo clinic experience

Published:December 31, 2022DOI:https://doi.org/10.1016/j.hpb.2022.12.006
Laparoscopic versus open liver resections for intrahepatic cholangiocarcinoma and gallbladder cancer: the Mayo clinic experience
Previous ArticleUtility and limitations of intraoperative frozen section diagnosis to determine optimal surgical strategy in suspected gallbladder malignancy
Next ArticleImpact of cumulative operative time on postoperative complication risk in simultaneous resections of colorectal liver metastases and primary tumors

      Abstract

      Background

      Data regarding laparoscopic liver resections(LLRs) for Gallbladder cancer(GBC) and Intrahepatic Cholangiocarcinoma(iCCA) are sparse. This study compared LLRs with open liver resections(OLRs) in a high-volume center.

      Methods

      Data of patients who underwent LLR or OLR for GBC or iCCA at Mayo-Clinic between 01/2016 and 04/2021 were retrospectively compared. Proportional hazards models were used to compare the approach on survival.

      Results

      32 and 52 patients underwent LLR and OLR during the study period, respectively. 64 and 20 patients had iCCA and GBC, respectively. LLR had lower median blood loss (250 mL vs. 475 mL, p = 0.001) and shorter median length of stay compared to OLR (3.0 days vs. 6.0 days, p = 0.001). LLR and OLR did not differ in post-operative major complication (25% vs. 32.7%, p = 0.62), negative margin (100% vs. 90.4%, p = 0.15) and completeness of lymphadenectomy rates (36.8% vs. 45.5%, p = 0.59). The median number of harvested lymph node was 4.0 and 5.0 for LLR and OLR, respectively (p = 0.347). There were no associations between approach and 3-year overall and disease-free survival between LLR and OLR (49.8% vs. 63.2% and 39.6% vs. 21.5%, p = 0.66 and p = 0.69).

      Discussion

      With appropriate patient selection and when compared to OLRs, LLRs for GBC and iCCA are feasible, safe and offer potential short-term benefits without compromising on oncological resection principals and long-term outcomes.

      Graphical abstract

      Image 1
      Graphical Abstract
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to HPB
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Register: Create an account
      Institutional Access: Sign in to ScienceDirect

      References

        • Carriaga M.T.
        • Henson D.E.
        Liver, gallbladder, extrahepatic bile ducts, and pancreas.
        Cancer. 1995; 75: 171-190
        View in Article
        • Cubertafond P.
        • Mathonnet M.
        • Gainant A.
        • Launois B.
        Radical surgery for gallbladder cancer. Results of the French surgical association survey.
        Hepato-Gastroenterology. 1999; 46: 1567-1571
        View in Article
        • Nakeeb A.
        • Pitt H.A.
        • Sohn T.A.
        • Coleman J.
        • Abrams R.A.
        • Piantadosi S.
        • Piantadosi
        • et al.
        Cholangiocarcinoma. A spectrum of intrahepatic, perihilar, and distal tumors.
        Ann Surg. 1996; 224 (discussion 473-465): 463-473
        View in Article
        • Benson A.B.
        • D’Angelica M.I.
        • Abbott D.E.
        • Anaya D.A.
        • Anders R.
        • Are C.
        • et al.
        Hepatobiliary Cancers, Version 2.2021, NCCN Clinical Practice Guidelines in Oncology.
        J Natl Compr Canc Netw. 2021; 19: 541-565
        View in Article
        • Amin M.B.
        Intrahepatic bile ducts.
        in: Amin M.B. Edge S.B. Greene F.L. Byrd D.R. Brookland R.K. Washington M.K. AJCC cancer staging manual. 8th ed. Springer, Chicago, IL2017: 295-302
        View in Article
        • Amin M.B.
        Liver.
        in: Amin M.B. Edge S.B. Greene F.L. Byrd D.R. Brookland R.K. Washington M.K. AJCC cancer staging manual. 8th ed. Springer, Chicago, IL2017: 287-294
        View in Article
        • Amin M.B.
        • Greene F.L.
        • Edge S.B.
        • Compton C.C.
        • Gershenwald J.E.
        • Brookland R.K.
        • et al.
        The Eighth Edition AJCC Cancer Staging Manual: continuing to build a bridge from a population-based to a more “personalized” approach to cancer staging.
        CA A Cancer J Clin. 2017; 67: 93-99
        View in Article
        • Zhang X.F.
        • Chen Q.
        • Kimbrough C.W.
        • Beal E.W.
        • Lv Y.
        • Chakedis J.
        • et al.
        Lymphadenectomy for intrahepatic cholangiocarcinoma: has nodal evaluation been increasingly adopted by surgeons over time? A National Database analysis.
        J Gastrointest Surg. 2018; 22: 668-675
        View in Article
        • Bagante F.
        • Spolverato G.
        • Weiss M.
        • Alexandrescu S.
        • Marques H.P.
        • Aldrighetti L.
        • et al.
        Assessment of the lymph node status in patients undergoing liver resection for intrahepatic cholangiocarcinoma: the New eighth edition AJCC staging system.
        J Gastrointest Surg. 2018; 22: 52-59
        View in Article
        • Sahara K.
        • Tsilimigras D.I.
        • Maithel S.K.
        • Abbott D.E.
        • Poultsides G.A.
        • Hatzaras I.
        • et al.
        Survival benefit of lymphadenectomy for gallbladder cancer based on the therapeutic index: an analysis of the US extrahepatic biliary malignancy consortium.
        J Surg Oncol. 2020; 121: 503-510
        View in Article
        • Zhang X.F.
        • Xue F.
        • Dong D.H.
        • Weiss M.
        • Popescu I.
        • Marques H.P.
        • et al.
        Number and station of lymph node metastasis after curative-intent resection of intrahepatic cholangiocarcinoma impact prognosis.
        Ann Surg. 2021; 274: e1187-e1195
        View in Article
        • Tsilimigras D.I.
        • Hyer J.M.
        • Paredes A.Z.
        • Moris D.
        • Beal E.W.
        • Merath K.
        • et al.
        The optimal number of lymph nodes to evaluate among patients undergoing surgery for gallbladder cancer: correlating the number of nodes removed with survival in 6531 patients.
        J Surg Oncol. 2019; 119: 1099-1107
        View in Article
        • Ciria R.
        • Cherqui D.
        • Geller D.A.
        • Briceno J.
        • Wakabayashi G.
        Comparative short-term benefits of laparoscopic liver resection: 9000 cases and climbing.
        Ann Surg. 2016; 263: 761-777
        View in Article
        • Bryant R.
        • Laurent A.
        • Tayar C.
        • Cherqui D.
        Laparoscopic liver resection-understanding its role in current practice: the Henri Mondor Hospital experience.
        Ann Surg. 2009; 250: 103-111
        View in Article
        • Buell J.F.
        • Cherqui D.
        • Geller D.A.
        • O’Rourke N.
        • Iannitti D.
        • Dagher I.
        • et al.
        The international position on laparoscopic liver surgery: the Louisville Statement.
        Ann Surg. 2008; 250 (2009): 825-830
        View in Article
        • Kazaryan A.M.
        • Pavlik Marangos I.
        • Rosseland A.R.
        • Rosok B.I.
        • Mala T.
        • Villanger O.
        • et al.
        Laparoscopic liver resection for malignant and benign lesions: ten-year Norwegian single-center experience.
        Arch Surg. 2010; 145: 34-40
        View in Article
        • Komatsu S.
        • Scatton O.
        • Goumard C.
        • et al.
        Development process and technical aspects of laparoscopic hepatectomy: learning curve based on 15 Years of experience.
        J Am Coll Surg. 2017; 224: 841-850
        View in Article
        • Nguyen K.T.
        • Gamblin T.C.
        • Geller D.A.
        World review of laparoscopic liver resection-2,804 patients.
        Ann Surg. 2009; 250: 831-841
        View in Article
        • Wakabayashi G.
        • Cherqui D.
        • Geller D.A.
        • Buell J.F.
        • Kaneko H.
        • Han H.S.
        • et al.
        Recommendations for laparoscopic liver resection: a report from the second international consensus conference held in Morioka.
        Ann Surg. 2015; 261: 619-629
        View in Article
        • He J.
        • Amini N.
        • Spolverato G.
        • Hirose K.
        • Makary K.
        • Wolfgang C.L.
        • et al.
        National trends with a laparoscopic liver resection: results from a population-based analysis.
        HPB. 2015; 17: 919-926
        View in Article
        • Kang S.H.
        • Choi Y.
        • Lee W.
        • Ahn S.
        • Cho J.Y.
        • Yoon Y.S.
        • et al.
        Laparoscopic liver resection versus open liver resection for intrahepatic cholangiocarcinoma: 3-year outcomes of a cohort study with propensity score matching.
        Surg Oncol. 2020; 33: 63-69
        View in Article
        • Zureikat A.H.
        • Borrebach J.
        • Pitt H.A.
        • McGill D.
        • Hogg M.E.
        • Thompson V.
        • et al.
        Minimally invasive hepatopancreatobiliary surgery in North America: an ACS-NSQIP analysis of predictors of conversion for laparoscopic and robotic pancreatectomy and hepatectomy.
        HPB. 2017; 19: 595-602
        View in Article
        • Cannon R.M.
        • Scoggins C.R.
        • Callender G.G.
        • McMasters K.M.
        • Martin 2nd, R.C.
        Laparoscopic versus open resection of hepatic colorectal metastases.
        Surgery. 2012; 152 (discussion 573-564): 567-573
        View in Article
        • Schiffman S.C.
        • Kim K.H.
        • Tsung A.
        • Marsh J.W.
        • Geller D.A.
        Laparoscopic versus open liver resection for metastatic colorectal cancer: a metaanalysis of 610 patients.
        Surgery. 2015; 157: 211-222
        View in Article
        • Shiraiwa D.K.
        • Carvalho P.
        • Maeda C.T.
        • Silva L.C.
        • Forones N.M.
        • Lopes-Filho G.J.
        • et al.
        The role of minimally invasive hepatectomy for hilar and intrahepatic cholangiocarcinoma: a systematic review of the literature.
        J Surg Oncol. 2020; 121: 863-872
        View in Article
        • Ziogas I.A.
        • Esagian S.M.
        • Giannis D.
        • Hayat M.H.
        • Kosmidis D.
        • Matsuoka L.K.
        • et al.
        Laparoscopic versus open hepatectomy for intrahepatic cholangiocarcinoma: an individual patient data survival meta-analysis.
        Am J Surg. 2021; 222: 731-738
        View in Article
        • Machairas N.
        • Lang H.
        • Jayant K.
        • Raptis D.A.
        • Sotiropoulos G.C.
        Intrahepatic cholangiocarcinoma: limitations for resectability, current surgical concepts and future perspectives.
        Eur J Surg Oncol. 2020; 46: 740-746
        View in Article
        • Clavien P.A.
        • Barkun J.
        • de Oliveira M.L.
        • Vauthey J.N.
        • Dindo D.
        • Schulick R.D.
        • et al.
        The Clavien-Dindo classification of surgical complications: five-year experience.
        Ann Surg. 2009; 250: 187-196
        View in Article
        • Guerrini G.P.
        • Esposito G.
        • Tarantino G.
        • Serra V.
        • Olivieri T.
        • Catellani B.
        • et al.
        Laparoscopic versus open liver resection for intrahepatic cholangiocarcinoma: the first meta-analysis.
        Langenbeck’s Arch Surg. 2020; 405: 265-275
        View in Article
        • Machairas N.
        • Kostakis I.D.
        • Schizas D.
        • Kykalos S.
        • Nikiteas N.
        • Sotiropoulos G.C.
        Meta-analysis of laparoscopic versus open liver resection for intrahepatic cholangiocarcinoma.
        Updates Surg. 2021; 73: 59-68
        View in Article
        • Navarro J.G.
        • Kang I.
        • Hwang H.K.
        • Yoon D.S.
        • Lee W.J.
        • Kang C.M.
        Oncologic safety of laparoscopic radical cholecystectomy in pT2 gallbladder cancer: a propensity score matching analysis compared to open approach.
        Medicine (Baltim). 2020; 99e20039
        View in Article
        • Wei F.
        • Wang G.
        • Ding J.
        • Dou C.
        • Yu T.
        • Zhang C.
        Is it time to consider laparoscopic hepatectomy for intrahepatic cholangiocarcinoma? A meta-analysis.
        J Gastrointest Surg. 2020; 24: 2244-2250
        View in Article
        • Lurje G.
        • Bednarsch J.
        • Czigany Z.
        • Lurje I.
        • Schlebusch I.K.
        • Boecker J.
        • et al.
        The prognostic role of lymphovascular invasion and lymph node metastasis in perihilar and intrahepatic cholangiocarcinoma.
        Eur J Surg Oncol. 2019; 45: 1468-1478
        View in Article
        • Choi S.B.
        • Kim K.S.
        • Choi J.Y.
        • Park S.W.
        • Choi J.S.
        • Lee W.J.
        • et al.
        The prognosis and survival outcome of intrahepatic cholangiocarcinoma following surgical resection: association of lymph node metastasis and lymph node dissection with survival.
        Ann Surg Oncol. 2009; 16: 3048-3056
        View in Article

      Article info

      Publication history

      Published online: December 31, 2022
      Accepted: December 30, 2022
      Received: September 23, 2022

      Identification

      DOI: https://doi.org/10.1016/j.hpb.2022.12.006

      Copyright

      © 2023 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

      ScienceDirect

      Access this article on ScienceDirect

      The content on this site is intended for healthcare professionals.


      We use cookies to help provide and enhance our service and tailor content. To update your cookie settings, please visit the Cookie Preference Center for this site.
      Copyright © 2023 Elsevier Inc. except certain content provided by third parties.


      RELX