Laparoscopic hepatectomy has better clinical outcomes compared to open hepatectomy in patients with intrahepatic cholangiocarcinoma (ICC), at least 60 years of age, found a new study published in the World Journal of Surgical Oncology. Moreover, the approach achieved long-term prognoses comparable to open surgery. 

Based on these findings, the authors of the study concluded that laparoscopic hepatectomy is “safe, reliable, and feasible” for the treatment of this group of patients. 

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Laparoscopic surgical excision is the primary treatment recommended for liver cancers. However, it is not known whether or not it can be beneficial in patients, who are at least 60 years of age.

Here, a team of researchers from China evaluated the feasibility, safety, and clinical outcomes of laparoscopic hepatectomy in patients with ICC, who are at least 60 years of age.

For the study, they recruited a total of 107 patients who either underwent laparoscopic hepatectomy or open hepatectomy to treat their disease. 

They then compared the short and long-term outcomes of the 2 approaches.

They found that patients who underwent laparoscopic hepatectomy had more favorable short-term outcomes compared to those who underwent open hepatectomy. For example, the incision length was shorter, the levels of total bilirubin following the operation were lower, and the length of hospital stay after the operation was shorter in patients who underwent laparoscopic hepatectomy.

However, when they compared the rate of postoperative complications, lymph node dissection, and R0 resection between the 2 groups of patients, the researchers found no significant differences. Similarly, there were no significant differences between the 2 groups in terms of long-term outcomes including overall and disease-free survival

The team identified cancer antigen-19-9 (CA-19-9) and pathological differentiation as independent prognostic factors for overall survival and CA-19-9 and neutrophil count as independent prognostic factors for disease-free survival.

Reference

Wang J, Wang W, Chen X, et l. Laparoscopic versus open hepatectomy for intrahepatic cholangiocarcinoma in patients aged 60 and older: a retrospective cohort study. World J Surg Oncol. Published online December 13, 2022. doi:10.1186/s12957-022-02870-1