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20.03.2019 | Hepatobiliary Tumors | Ausgabe 6/2019

Annals of Surgical Oncology 6/2019

Laparoscopic Approach to Intrahepatic Cholangiocarcinoma is Associated with an Exacerbation of Inadequate Nodal Staging

Zeitschrift:
Annals of Surgical Oncology > Ausgabe 6/2019
Autoren:
DO Sean P. Martin, MD Justin Drake, MD Michael M. Wach, MD Samantha Ruff, MD Laurence P. Diggs, PhD Jim Y. Wan, DO Zachary J. Brown, MD Reed I. Ayabe, MD Evan S. Glazer, MD Paxton V. Dickson, MD Jeremy L. Davis, DO Jeremiah L. Deneve, MD Jonathan M. Hernandez
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Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1245/​s10434-019-07303-0) contains supplementary material, which is available to authorized users.

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Abstract

Introduction

Laparoscopic approach to liver resection is feasible and safe, though its utilization with intrahepatic cholangiocarcinoma (ICC) remains poorly documented. We sought to evaluate the use laparoscopy for ICC, and to examine adherence to oncologic standards.

Methods

The National Cancer Database was queried for patients who underwent resection for ICC. Patients were stratified by laparoscopic (LLR) versus open liver resection (OLR). Clinicopathologic parameters and hospital volumes were recorded.

Results

In total, 2309 patients with ICC underwent hepatic resection (1997 OLR, 312 LLR) between 2010 and 2015. LLR increased from 12 to 16% during the study period and was utilized more commonly than OLR for wedge and segmental resections (56% vs. 33%, p < 0.001). Nodal evaluation was performed in 58% of all patients with ICC and was significantly more common in patients undergoing OLR (61%, n = 1210) versus LLR (39%, n = 120), p < 0.001. Of the 120 patients undergoing LLR with any nodal evaluation, 31% (n = 37) had a single node evaluated. Patients who underwent LLR were less likely to have ≥ 6 lymph nodes evaluated compared with those who underwent OLR (9% vs. 15%, respectively, p < 0.001).

Conclusions

The use of laparoscopy for ICC is associated with an exacerbation of inadequate nodal evaluation compared with open resections.

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