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Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:

2022 01

Page:

77-84

Research Field:

Publishing date:

Info

Title:

Laparoscopic versus open radical resection for hilar cholangiocarcinoma:A Meta-analysis

Author(s):

ZHANG Mingxiong¹; ZHENG Mengqiu²; YANG Quan¹; WANG Xiaohuai¹; ZHANG Xiaowen³

1.Yunnan Cancer Hospital/Yunnan Cancer Center,Yunnan Kunming 650118，China;2.Neonatal Department,Kunming Maternal and Child Health Hospital,Yunnan Kunming 650031，China;3.the Second Affiliated Hospital of Kunming Medical University，the Second Ward of Hepato

Keywords:

hilar cholangiocarcinoma; laparoscopy; open surgery; radical resection; Meta-analysis

PACS:

R735.7

DOI:

10.3969/j.issn.1672-4992.2022.01.017

Abstract:

Objective:To systematically evaluate the clinic effect of laparoscopic versus open radical resection for hilar cholangiocarcinoma.Methods:Databases including PubMed,EMbase,the Cochrane Library,CBM,CNKI and VANFUN were searched for from January 1960 to December 2020 with the key words including "laparoscopy,laparoscopic,laparotomy,open surgery,bile duct neoplasms,hilar cholangiocarcinoma".Reviewed the literature,extracted the data,and evaluated the quality using the Cochrane systematic review method.The statistical analysis was performed using Review Manager version 5.3.Continuous variables were calculated by the mean differences(MD) with 95% confidence interval(CI),whereas dichotomous variables were calculated by odds ratio(OR) with 95%CI.The heterogeneitv of the studies included was analyzed using the I2 test．Funnel plotwas used to testpotential publication bias if the studies included≥5，and no test was needed if the studies included<5．Results:Document retrieval:8 relevant literatures conforming to the standards were included.There were 329 patients,including 160 patients in LRRHC group and 169 patients in ORRHC group.The Meta analysis results LRRHC group had a longer operation time,less intraoperative blood loss,postoperative analgesia,postoperative complications and postoperative hospital stay,the difference was statistically significant(P＜0.05).There were no statistically significant differences between the LRRHC group and ORRHC group in the number of lymph node dissection,R0 resection,postoperative feeding time,1-year and 2-year survival rates(＞0.05).Funnel plot analysiswas carried out in 8 literatures which shape was symmetrical,indicating that publication bias had little influence on Meta analysis results.Conclusion:LRRHC is safe and feasible in the treatment of hilar cholangiocarcinoma at the experienced clinical medical center for hepatobiliary and pancreatic diseases.Although LRRHC have a longer operation time than ORRHC,but LRRHC had less trauma,less intraoperative blood loss,better postoperative analgesia effect,lower incidence of postoperative complications and shorter hospitalization time,and the lymph node in number,R0 resection rate,postoperative eating time,1-year and 2-year survival rate were comparable to ORRHC.

References:

[1] KLATSKIN G.Adenocarcinoma of the hepatic duct at its bifurcation within the porta hepatis.Anunusual tumor with distinctive clinical and pathological features［J］.Am J Med,1965，38(2):241-256.
[2] VAN VUGT JLA,GASPERSZ MP,COELEN RJS,et al.The prognostic value of portal vein and hepatic artery involvement in patients with perihilar cholangiocarcinoma［J］.HPB,2018,20(1):83-92.
[3]张明雄,刘立鑫,郑梦秋,等.肝门部胆管癌的外科治疗进展［J］.肝胆胰外科杂志,2020,32(2):116-121. ZHANG MX,LIU LX,ZHENG MQ,et al.Progress on surgical treatment of hilarcholangiocarcinoma［J］.Journal of Hepatopancreatobiliary Surgery,2020,32(2):116-121.
[4]HU HJ,WU ZR,JIN YW,et al.Minimally invasive surgery for hilar cholangiocarcinoma:state of art and future perspectives［J］.ANZ J Surg,2019,89(5):476-480.
[5]TIAN Y,LIU L,YEOLKAR NV,et al.Diagnostic role of staging laparoscopy in a subset of biliary cancers:a meta-analysis［J］.ANZ J Surg,2017,87(1-2):22-27.
[6]RAHNEMAI-AZAR AA,ABBASI A,TSILIMIGRAS DI,et al.Laparoscopy in the management of hilar cholangiocarcinoma［J］.J Gastrointest Surg,2020,24(9):2143-2149.
[7]STANG A.Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of non randomized studies in meta-analyses［J］.Eur J Epidemiol,2010,25(9):603-605.
[8]宫金伟,刘春富.腹腔镜与开腹肝门部胆管癌根治术的对比研究［J］.腹腔镜外科杂志,2014,19(5):321-324. GONG JW,LIU CF.The comparative study of laparoscopic and open radical operation for hilar cholangiocarcinoma［J］.Journal of Laparoscopic Surgery,2014,19(5):321-324.
[9] 朱鸿超,周龙飞,刘天德,等.腹腔镜与开腹Bismuth-Ⅰ型肝门胆管癌根治术的疗效分析［J］.中国内镜杂志,2018,24(2):10-15. ZHU HC,ZHOU LF,LIU TD,et al.Analysis of laparoscopic and open radical resection for hilar cholangiocarcinoma of type Bismuth-I［J］.China Journal of Endoscopy,2018,24(2):10-15.
[10] 段畅,朱求实,王满贞,等.两种手术方法在Bismuth-Ⅰ型肝门胆管癌根治术的临床疗效研究［J］.中华普外科手术学杂志（电子版）,2019,13(6):552-555. DUAN C,ZHU QS,WANG MZ,et al.Clinical investigation of two surgical methods in radical resection of Bismuth-Ⅰhilar cholangiocarcinoma［J］.Chin J Oper Proc Gen Surg(Electronic Edition),2019,13(6):552-555.
[11] 钟其焕,陈博艺,邓国荣,等.腹腔镜胆管癌根治性切除术治疗Bismuth-Corlette Ⅰ、Ⅱ型肝门胆管癌的临床观察［J］.消化肿瘤杂志（电子版）,2019,11(4):331-335. ZHONG QH,CHEN BY,DENG GR,et al.Clinical obeservation of laparoscopic radical resection of cholangiocarcinoma for Bismuth-Corlette type I and II hilar chalangiocarcinoma［J］.J Dig Oncol(Electronic Version),2019,11(4):331-335.
[12] 柴伟,张执全,雷豹,等.全腹腔镜与开腹Bismuth-Ⅲb型肝门胆管癌根治术的临床研究［J］.中华普通外科杂志,2019,34(5):377-380. CHAI W,ZHANG ZQ,LEI B,et al.A case macthed study on laparoscopic versus open radical resection for Bismuth-type IIIb hilar chalangiocarcinoma［J］.Chin J Gen Surg,2019,34(5):377-380.
[13]ZHANG Y,DOU C,WU W,et al.Total laparoscopic versus open radical resection for hilarcholangiocarcinoma［J］.Surg Endos,2019,34(10):4382-4387.
[14]蒋维香,周棱,胡雅娇.Bismuth-Ⅰ型肝门胆管癌不同手术方案疗效对比［J］.中华普外科手术学杂志（电子版）,2020,14(1):78-80. JIANG WX,ZHOU L,HU YJ.Comparison of different surgical procedures for Bismuth-type I hilar cholangiocarcinoma［J］.Chin J Oper Proc Gen Surg(Electronic Edition),2020,14(1):78-80.
[15]阿牛木果.肝门部胆管癌：对比腹腔镜和开腹手术的回顾性研究［D］.济南:山东大学,2020. ANIUMUGUO.A retrospective study of laparoscopic and open radical resection for hilar chilangiocarcinoma［D］.Jinan:Shandong University,2020.
[16]LIU R,WANG Y,ZHOU N.A case of laparoscopic left hepatectomy for hilar cholangiocarcinoma［J］.Chin J Hepatobiliary Surg,2003,09:384.
[17]腹腔镜肝门部胆管癌根治切除术操作规范专家组,中华外科杂志编辑部.腹腔镜肝门部胆管癌根治性切除操作流程专家建议［J］.中华外科杂志,2019,57(8):561-567. The Expert Group on Operational Norms of Laparoscopic Radical Resection of Perihilar Cholangiocarcinoma，Editorial Board of Chinese Journal of Surgery.Expert recommendation for operational norms of laparoscopic radical resection of perihilar cholangiocarcinoma［J］.Chin J Surg,2019,57(8):561-567.
[18]CHEN Y,XU Y,ZHANG Y.Current status of laparoscopic radical hilar cholangiocarcinoma in Mainland China［J］.Biosci Trends,2020,14(3):168-173.
[19]BUETTNER S,MARGONIS GA,KIM Y,et al.Conditional probability of long-term survival after resection of hilar cholangiocarcinoma［J］.HPB(Oxford),2016,18(6):510-517.
[20]TAE YOO，SANG-JAE PARK，SUNG-SIK HAN，et al． Proximal resection margins:More prognostic than distal resection margins in patients undergoing hilar cholangiocarcinoma resection［J］.Cancer Res Treat,2018,50(4):1106-1113．
[21]刘钢山,吴硕东,范莹.肝门部胆管癌的分类、治疗及预后因素概述［J］.现代肿瘤医学,2020,28(19):3442-3446. LIU GS,WU SD,FAN Y.An overview of the classification，treatment and prognostic factors for hilar cholangiocarcinoma［J］.Modern Oncology,2020,28(19):3442-3446.
[22]NAGINO M,EBATA T,YOKOYAMA Y,et al.Evolution of surgical treatment for perihilar cholangiocarcinoma:a single-center 34-year review of 574 consecutive resections［J］.Ann Surg,2013,258(1):129-140.
[23]NIMURA Y,KAMIYA J,KONDO S,et al.Aggressive preoperativemanagement and extended surgery for hilar cholangiocarcinoma:Nagoya experience［J］.J Hepatobiliary Pancreat Surg,2000,7(2):155-162.
[24]中华医学会外科学分会胆道外科学组,解放军全军肝胆外科专业委员会.肝门部胆管癌诊断和治疗指南(2013版) ［J］.中华外科杂志,2013,51(10):865-871. The Biliary Duct Surgery Group of Surgery Branch of Chinese Medical Association.The Professional committee member of hepatobiliary surgery department of the whole PLA army.Guidelines for the Diagnosis and Treatment of Hilar Cholangiocarcinoma(2013 Edition) ［J］.Chin J Surg,2013,51(10):865-871.

Memo

Memo:

National Natural Science Foundation of China(No.81760430）；国家自然科学基金资助项目（编号：81760430）

Common functions

Last Update: 2021-12-02