Laparoscopic versus open liver resection for intrahepatic cholangiocarcinoma: a systematic review of propensity score-matched studies

被引:2
|
作者
Hu, Ya-Fei [1 ]
Hu, Hai-Jie [1 ]
Ma, Wen-Jie [1 ]
Jin, Yan-Wen [1 ]
Li, Fu-Yu [1 ]
机构
[1] Sichuan Univ, Dept Biliary Surg, West China Hosp, Chengdu 610041, Sichuan, Peoples R China
基金
中国国家自然科学基金;
关键词
Intrahepatic cholangiocarcinoma (ICCA); Laparoscopic liver resection (LLR); Open liver resection (OLR); Propensity score-matched studies (PSM); OUTCOMES; TRANSPLANTATION; FEASIBILITY; PROGNOSIS; SAFETY; COHORT;
D O I
10.1007/s13304-023-01648-8
中图分类号
R61 [外科手术学];
学科分类号
摘要
Outcomes of laparoscopic liver resection (LLR) versus open LR (OLR) for intrahepatic cholangiocarcinoma (ICCA) are heterogeneous. We aimed to compare LLR and OLR for ICCA based on propensity-score-matched (PSM) studies. Two reviewers independently searched the online databases (PubMed, Embase, and Cochrane Library) for PSM studies that compared LLR and OLR for ICCA. The Ottawa-Newcastle Quality Assessment Scale with a cutoff of >= 7 was used to define higher-quality literature. Only 'high-quality' PSM analyses of the English language that met all our inclusion criteria were considered. A total of ten PSM trials were included in the analyses. Compared with OLR, although the lymph node dissection (LND) (RR = 0.67) and major hepatectomy rates were lower in the LLR group (RR = 0.87), higher R0 resections (RR = 1.05) and lower major complications (Clavien-Dindo grade >= III) (RR = 0.72) were also observed in the LLR group. In addition, patients in the LLR group showed less estimated blood loss (MD = - 185.52 ml) and shorter hospital stays as well (MD = - 2.75 days). Further analysis found the overall survival (OS) (HR = 0.91), disease-free survival (DFS) (HR = 0.95), and recurrence-free survival (HR = 0.80) for patients with ICCA after LLR were all comparable to those of OLR. LLR for selected ICCA patients may be technically safe and feasible, providing short-term benefits and achieving oncological efficacy without compromising the long-term survival of the patients.
引用
收藏
页码:2049 / 2061
页数:13
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