A study comparing the outcomes of minimally invasive and open pancreatoduodenectomy for the treatment of distal cholangiocarcinoma has been completed.
The international multicenter propensity score matched cohort study included 478 patients with distal cholangiocarcinoma treated with minimally invasive open pancreatoduodenectomy. The primary outcome measure of the study was the overall survival and disease-free interval. The secondary outcome measure was major morbidity.
Investigators used the database of the International Study Group on Non-Pancreatic Periampullary Cancer (ISGACA) to compare the outcomes of the 2 approaches.
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The minimally invasive group included patients who underwent Whipple or pylorus-preserving pancreatoduodenectomy after laparoscopic or robotic surgery. Hand-assisted hybrid procedures were also included. The open pancreatoduodenectomy group included patients who underwent Whipple or pylorus-preserving pancreatoduodenectomy after laparotomy.
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Patients who underwent neoadjuvant chemotherapy and palliative surgical procedures were excluded. Those diagnosed with metastasis or locally advanced disease during the operation or those who were diagnosed with cancer other than distal cholangiocarcinoma, such as a neuroendocrine tumor or polyposis adenoma, after surgery were also excluded.
The study took place and was sponsored by Fondazione Poliambulanza Istituto Ospedaliero in Brescia, Italy. It started on November 1, 2021, and was completed on July 1, 2022. Results are not yet available.
There are 2 types of cholangiocarcinoma: intrahepatic and extrahepatic. Extrahepatic cholangiocarcinoma is further divided into distal and peripheral disease. Distal cholangiocarcinoma makes up around 20% to 30% of extrahepatic cholangiocarcinoma cases, which is the most common subtype of cancer outside East Asian countries.
The surgical treatment of distal cholangiocarcinoma involves an extended hepatectomy and a pancreaticoduodenectomy (Whipple procedure).
The outcomes of minimally invasive and open pancreatoduodenectomy in the treatment of distal cholangiocarcinoma have not been compared previously.
Reference
Minimally invasive pancreatoduodenectomy for distal cholangiocarcinoma. US National Library of Medicine. Last updated July 28, 2022. Accessed August 1, 2022.
