Abstract
Objective
To compare the effects of laparoscopic hepatectomy (LH) versus open hepatectomy (OH)
on the short-term and long-term outcomes of patients with intrahepatic cholangiocarcinoma
(ICC) through a meta-analysis of studies using propensity score-matched cohorts.
Methods
The literature search was conducted in PubMed, Embase, and Cochrane Library databases
until August 31, 2022. Meta-analysis of surgical (major morbidity, the length of hospital
stay, 90-day postoperative mortality), oncological (R0 resection rate, lymph node
dissection rate) and survival outcomes (1-, 3-, and 5-year overall survival and disease-free
survival) was performed using a random effects model. Data were summarized as relative
risks (RR), mean difference (MD) and hazard ratio (HR) with 95% confidence intervals
(95% CI).
Results
Six case-matched studies with 1054 patients were included (LH 518; OH 536). Major
morbidity was significantly lower (RR = 0.57, 95% CI = 0.37–0.88, P = 0.01) and the
length of hospital stay was significantly shorter (MD = −2.44, 95% CI = −4.19 to −0.69,
P = 0.006) in the LH group than in the OH group, but there was no significant difference
in 90-day postoperative mortality between the 2 groups. There were no significant
differences in R0 resection rate, lymph node dissection rate, 1-, 3-, and 5-year overall
survival or disease-free survival between the LH and OH groups.
Conclusions
LH has better surgical outcomes and comparable oncological outcomes and survival outcomes
than does OH on ICC. Therefore, laparoscopy is at least not inferior to open surgery
for intrahepatic cholangiocarcinoma.
Keywords
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Article info
Publication history
Published online: February 20, 2023
Accepted:
February 18,
2023
Received in revised form:
February 5,
2023
Received:
October 31,
2022
Identification
Copyright
© 2023 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
