Effectiveness Analysis of Laparoscopic and Open Surgeries in the Treatment of Intrahepatic Cholangiocarcinoma:a Propensity Score Matching Study
10.3969/j.issn.1009-6604.2024.07.001
- VernacularTitle:基于倾向性评分匹配的腹腔镜与开腹手术治疗肝内胆管癌疗效的初步分析
- Author:
Jie ZHANG
1
;
Bin JIANG
;
Fei PEI
;
Lingfu ZHANG
;
Chunhui YUAN
;
Xiaofeng LING
;
Dianrong XIU
Author Information
1. 北京大学第三医院普通外科,北京 100191
- Keywords:
Intrahepatic cholangiocarcinoma;
Laparoscopic surgery;
Open surgery
- From:
Chinese Journal of Minimally Invasive Surgery
2024;24(7):465-472
- CountryChina
- Language:Chinese
-
Abstract:
Objective To preliminarily analyze the efficacy of laparoscopic surgery versus open surgery in patients with intrahepatic cholangiocarcinoma(ICC).Methods A retrospective analysis was conducted on 84 patients with ICC who underwent surgical resection from September 2010 to March 2023,including 45 cases in the laparoscopic surgery group and 39 in the open surgery group.By using propensity score matching,34 matched pairs were successfully identified.The study compared intraoperative blood loss,proportion of achieving≥6 lymph nodes dissection,R0 resection rate,complication,postoperative hospital stay,survival,and recurrence between the two groups.Results In the laparoscopic group,intraoperative blood loss was significantly less than that in the open surgery group(median:250 ml vs.750 ml,Z=-3.406,P=0.001).The proportion of achieving≥6 lymph node dissection in the former was lower than that in the latter,but the difference was not statistically significant(5.9%vs.17.6%,χ2=1.275,P=0.259).There was no statistical difference in R0 resection rate between the laparoscopic group and the open surgery group[88.2%(30/34)vs.82.4%(28/34),χ2=0.469,P=0.493].The complication rate in the laparoscopic group was 17.6%(6/34),significantly lower than 47.1%(16/34)in the open surgery group(χ2=6.719,P=0.010);however,the rate of severe complication was the same in both groups at 2.9%(χ2=0.000,P=1.000).Laparoscopic surgery significantly shortened the postoperative hospital stay(median:7 d vs.10 d,Z=-3.021,P=0.003).The median overall survival in the laparoscopic group was 60.6 months,significantly longer than 15.9 months in the open surgery group(log-rank χ2=5.788,P=0.016).The median recurrence-free survival was 26.4 months in the laparoscopic group,significantly longer than 7.6 months in the open surgery group(log-rank χ2=4.532,P=0.033).Conclusions Compared to open surgery,laparoscopic surgery for ICC offers advantages such as less blood loss,lower complication rate,shorter postoperative hospital stay and longer survival.It achieves comparable R0 resection rate and adequate lymph node dissection.
