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Complete laparoscopic radical resection of hilar cholangiocarcinoma: technical aspects and long-term results from a single center
INTRODUCTION: The landscape of surgical treatments for hepatobiliary disease was significantly changed after the advent of laparoscopy. Many kinds of complex laparoscopic procedures can be routinely performed at present, but radical resection of hilar cholangiocarcinoma (HC) by laparoscopy is still...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Termedia Publishing House
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7991938/ https://www.ncbi.nlm.nih.gov/pubmed/33786118 http://dx.doi.org/10.5114/wiitm.2020.97363 |
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author | Li, Jingdong Xiong, Yongfu Yang, Gang Zhang, Lixing Riaz, Muhammad Xu, Jian Li, Qiang Tang, Zhaohui |
author_facet | Li, Jingdong Xiong, Yongfu Yang, Gang Zhang, Lixing Riaz, Muhammad Xu, Jian Li, Qiang Tang, Zhaohui |
author_sort | Li, Jingdong |
collection | PubMed |
description | INTRODUCTION: The landscape of surgical treatments for hepatobiliary disease was significantly changed after the advent of laparoscopy. Many kinds of complex laparoscopic procedures can be routinely performed at present, but radical resection of hilar cholangiocarcinoma (HC) by laparoscopy is still highly contentious. AIM: To describe our primary experience with laparoscopic radical resection for HC and determine the safety and feasibility of this procedure. MATERIAL AND METHODS: Between December 2015 and November 2019, 32 patients planned to undergo curative-intent laparoscopic resection of HC in our department. The perioperative and long-term outcomes of these patients were retrospectively analyzed. RESULTS: Laparoscopic surgery with radical resection was ultimately performed in 24 (75.0%) patients; 3 (9.3%) patients were found to be unresectable at the preliminary exploration stage, and 5 (15.7%) patients converted from laparoscopy to laparotomy. The operation time and blood loss were 476.95 ±133.89 min and 568.75 ±324.01 ml, respectively. A negative margin was achieved in 19 (79.1%) of the laparoscopy patients. Three (12.5%) patients were identified with microscopic positive margins, and 2 (8.4%) patients underwent macroscopic residual tumor resection (R2). The length of postoperative stay was 23.3 ±11.7 days. Severe morbidity occurred in 4 (16.6%) patients. The actuarial 3-year overall survival and disease-free survival for patients who underwent laparoscopic surgery were 49.1% and 47.0%, respectively. CONCLUSIONS: Laparoscopic radical resection for HC is safe and feasible in experienced hands for highly selected patients but is still in its initial stages. When adequate oncologic resection is performed, the laparoscopic approach does not adversely influence the prognosis of the patient. |
format | Online Article Text |
id | pubmed-7991938 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Termedia Publishing House |
record_format | MEDLINE/PubMed |
spelling | pubmed-79919382021-03-29 Complete laparoscopic radical resection of hilar cholangiocarcinoma: technical aspects and long-term results from a single center Li, Jingdong Xiong, Yongfu Yang, Gang Zhang, Lixing Riaz, Muhammad Xu, Jian Li, Qiang Tang, Zhaohui Wideochir Inne Tech Maloinwazyjne Original Paper INTRODUCTION: The landscape of surgical treatments for hepatobiliary disease was significantly changed after the advent of laparoscopy. Many kinds of complex laparoscopic procedures can be routinely performed at present, but radical resection of hilar cholangiocarcinoma (HC) by laparoscopy is still highly contentious. AIM: To describe our primary experience with laparoscopic radical resection for HC and determine the safety and feasibility of this procedure. MATERIAL AND METHODS: Between December 2015 and November 2019, 32 patients planned to undergo curative-intent laparoscopic resection of HC in our department. The perioperative and long-term outcomes of these patients were retrospectively analyzed. RESULTS: Laparoscopic surgery with radical resection was ultimately performed in 24 (75.0%) patients; 3 (9.3%) patients were found to be unresectable at the preliminary exploration stage, and 5 (15.7%) patients converted from laparoscopy to laparotomy. The operation time and blood loss were 476.95 ±133.89 min and 568.75 ±324.01 ml, respectively. A negative margin was achieved in 19 (79.1%) of the laparoscopy patients. Three (12.5%) patients were identified with microscopic positive margins, and 2 (8.4%) patients underwent macroscopic residual tumor resection (R2). The length of postoperative stay was 23.3 ±11.7 days. Severe morbidity occurred in 4 (16.6%) patients. The actuarial 3-year overall survival and disease-free survival for patients who underwent laparoscopic surgery were 49.1% and 47.0%, respectively. CONCLUSIONS: Laparoscopic radical resection for HC is safe and feasible in experienced hands for highly selected patients but is still in its initial stages. When adequate oncologic resection is performed, the laparoscopic approach does not adversely influence the prognosis of the patient. Termedia Publishing House 2020-07-16 2021-03 /pmc/articles/PMC7991938/ /pubmed/33786118 http://dx.doi.org/10.5114/wiitm.2020.97363 Text en Copyright: © 2020 Fundacja Videochirurgii http://creativecommons.org/licenses/by-nc-sa/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license. |
spellingShingle | Original Paper Li, Jingdong Xiong, Yongfu Yang, Gang Zhang, Lixing Riaz, Muhammad Xu, Jian Li, Qiang Tang, Zhaohui Complete laparoscopic radical resection of hilar cholangiocarcinoma: technical aspects and long-term results from a single center |
title | Complete laparoscopic radical resection of hilar cholangiocarcinoma: technical aspects and long-term results from a single center |
title_full | Complete laparoscopic radical resection of hilar cholangiocarcinoma: technical aspects and long-term results from a single center |
title_fullStr | Complete laparoscopic radical resection of hilar cholangiocarcinoma: technical aspects and long-term results from a single center |
title_full_unstemmed | Complete laparoscopic radical resection of hilar cholangiocarcinoma: technical aspects and long-term results from a single center |
title_short | Complete laparoscopic radical resection of hilar cholangiocarcinoma: technical aspects and long-term results from a single center |
title_sort | complete laparoscopic radical resection of hilar cholangiocarcinoma: technical aspects and long-term results from a single center |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7991938/ https://www.ncbi.nlm.nih.gov/pubmed/33786118 http://dx.doi.org/10.5114/wiitm.2020.97363 |
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