Laparoscopic liver resection to treat combined hepatocellular-cholangiocarcinoma is associated with less liver damage, better attenuates inflammatory response thus contributing to faster recovery, and demonstrates similar oncologic outcomes to open liver resection, a new study suggests.

Laparoscopic liver resection can, therefore, be recommended as a safe and effective therapeutic option for the treatment of some patients with the disease, reported Xiao-Ying Wang, of the Liver Cancer Institute at Zhongshan Hospital and Fudan University in Shanghai, and colleagues.

The results were published online in the journal Surgical Endoscopy.  

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Previous findings have shown that the approach is safe and effective in treating hepatocellular-carcinoma and intrahepatic-cholangiocarcinoma. However, its role in treating combined hepatocellular-cholangiocarcinoma is not clear. 

Read more about surgical care in cholangiocarcinoma

In the present study, a team of researchers in China compared the technique to open liver resection for the treatment of patients with combined hepatocellular-cholangiocarcinoma.

The study team analyzed 229 patients with combined hepatocellular-cholangiocarcinoma who had hepatic resection either laparoscopically (n=34) or with open surgery (n=195) between January 2014 and December 2018. Among those who had hepatic resection with open surgery, 68 of them were included in the analysis after propensity score matching. The investigators evaluated the patients’ perioperative and oncologic outcomes.

They found that patients who have had laparoscopic surgery had a shorter hospital stay after the operation than those who have had open surgery. Notably, there were no significant differences between the 2 groups of patients in terms of the incidence of complications and survival margin rate following the operation.

The liver enzymes aspartate aminotransferase (AST) and alanine aminotransferase (ALT), as well as inflammatory indicators, were significantly lower in the patients who had laparoscopic surgery compared to those who had open surgery on days 1 and 3 after the operation.

Finally, the overall and recurrence-free survivals of the patients were comparable between the 2 groups.

Laparoscopic liver resection can be an effective alternative for select patients with combined hepatocellular-cholangiocarcinoma, especially if they have small tumors in favorable locations, the study authors concluded.


Song DJ, Zhu K, Tan JP, et al. Perioperative and oncologic outcomes of laparoscopic versus open liver resection for combined hepatocellular-cholangiocarcinoma: a propensity score matching analysis. Surg Endosc. Published online September 8, 2022. doi:10.1007/s00464-022-09579-y