Laparoscopic or open liver resection for intrahepatic cholangiocarcinoma: A meta-analysis and systematic review

Xin Zhao; Feng-Wei Gao; Kang-Yi Jiang; Jie Yang; Qing-Yun Xie; Jie Gong; Man-Yu Yang; Tian-Yang Mao; Ze-Hua Lei

doi:10.3389/fonc.2023.1096714

Laparoscopic or open liver resection for intrahepatic cholangiocarcinoma: A meta-analysis and systematic review

Front Oncol. 2023 Mar 1:13:1096714. doi: 10.3389/fonc.2023.1096714. eCollection 2023.

Authors

Xin Zhao^{1

2}, Feng-Wei Gao^{1

2

3}, Kang-Yi Jiang^{1

2}, Jie Yang^{1

2}, Qing-Yun Xie^{1

2}, Jie Gong^{1

2}, Man-Yu Yang³, Tian-Yang Mao³, Ze-Hua Lei^{1

2}

Affiliations

¹ Department of Hepatopancreatobiliary Surgery, The People's Hospital of Leshan, Leshan, Sichuan, China.
² Diagnosis and Treatment Center for Liver, Gallbladder, Pancreas and Spleen System Diseases of Leshan, Leshan, Sichuan, China.
³ North Sichuan Medical College, Nanchong, Sichuan, China.

Abstract

Background: Although laparoscopic hepatectomy has been widely used in the treatment of benign and malignant liver diseases, its applicability in intrahepatic cholangiocarcinoma (ICC) is controversial. We conducted a meta-analysis to compare the short-term and long-term outcomes of laparoscopic hepatectomy (Lap-ICC) and open hepatectomy (Open-ICC) in ICC patients.

Methods: The PubMed, Web of science, Cochrane Library, China National Knowledge Infrastructure and other databases were searched for the relevant literature. The research data were extracted according to the inclusion and exclusion criteria.

Results: Seventeen studies, including 3975 ICC patients, were selected for the meta-analysis. Compared to Open-ICC, Lap-ICC had lower rates of lymph node dissection (OR=0.44, P=0.01) and metastasis (OR=0.58, P=0.03), along with less intraoperative bleeding (MD=-128.43 ml, P<0.01) lower blood transfusion rate (OR=0.43, P<0.01), shorter hospital stay (MD=-2.75 day, P<0.01), higher R0 resection rate (OR=1.60, P<0.01), and lower tumor recurrence rate (OR=0.67, P=0.01). However, there was no difference between the two groups in terms of operation time, number of lymph node dissection, incision margin distance, overall complications rate, severe complications rate, and the 1-, 3- and 5-year DFS and OS rates.

Conclusion: Laparoscopic hepatectomy is partially superior to open hepatectomy in terms of less bleeding, shorter hospital stay and higher R0 resection rate, while the long-term efficacy of the two approaches is similar.

Keywords: hepatectomy; intrahepatic cholangiocarcinoma; laparoscopy; laparotomy; meta-analysis.

Publication types

Review