Walid Elmoghazy1,2, Jane Cowan3, Nicolas Tabchouri3, Pascale Tinguely3, Mostefa Bennamoun4, Candice Tubbax3, Anthony Sarran5, Marine Lefevre6, Christian Lamer7, Brice Gayet3,8, David Fuks3,8. 1. Department of Digestive, Oncological and Metabolic Surgery - Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014, Paris, France. moghazyw@gmail.com. 2. Department of Surgery, Sohag University, Sohag, Egypt. moghazyw@gmail.com. 3. Department of Digestive, Oncological and Metabolic Surgery - Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014, Paris, France. 4. Department of Oncology - Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014, Paris, France. 5. Department of Radiology - Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014, Paris, France. 6. Department of Pathology - Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014, Paris, France. 7. Department of Intensive Care Unit - Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014, Paris, France. 8. Université Paris Descartes, 15 Rue de l'École de Médecine, 75005, Paris, France.
Abstract
BACKGROUND: Laparoscopic liver resection (LLR) has evolved over time, yet its role in extra-pancreatic biliary cancer has been limited due to several factors. We aimed to evaluate the short-term outcome of LLR in extra-pancreatic biliary tract cancer. METHODS: From January 2002 to 2016, all patients who underwent LLR for extra-pancreatic biliary tract cancer including gallbladder cancer (GBC), intra-hepatic cholangiocarcinoma (ICC), and peri-hilar cholangiocarcinoma (PHC) with curative intent (R0 or R1) at Institute Mutualiste Montsouris were identified from prospectively collected databases. Patient characteristics, and perioperative outcomes, were analyzed in all three groups. RESULTS: A total of 35 patients were included: 10 with GBC, 14 with ICC, and 11 with PHC. There were 19 (54%) women and median age was 71 years. Median operative time was 240 min, and estimated blood loss was 200 ml. Conversion to an open procedure was more common in patients with PHC (45% vs. 7% for ICC and 0% for GBC, p = 0.010). R0 resection was achieved in 10 (100%), 12 (86%), and 8 (73%) patients in GBC, ICC, and PHC groups, respectively (p = 0.204). Postoperative morbidity was reported in 19 (54%) patients of whom 12 (34%) had minor complications. Postoperative mortality was reported in 4 (11%) patients; one (7%) in GBC group, one (7%) in ICC group, and two (18%) in PHC, p = 0.681. Median hospital stay was 11 days. CONCLUSIONS: The present series suggests that LLR is feasible in GBC, challenging but achievable in ICC but unsuitable for the moment in PHC.
BACKGROUND: Laparoscopic liver resection (LLR) has evolved over time, yet its role in extra-pancreatic biliary cancer has been limited due to several factors. We aimed to evaluate the short-term outcome of LLR in extra-pancreatic biliary tract cancer. METHODS: From January 2002 to 2016, all patients who underwent LLR for extra-pancreatic biliary tract cancer including gallbladder cancer (GBC), intra-hepatic cholangiocarcinoma (ICC), and peri-hilar cholangiocarcinoma (PHC) with curative intent (R0 or R1) at Institute Mutualiste Montsouris were identified from prospectively collected databases. Patient characteristics, and perioperative outcomes, were analyzed in all three groups. RESULTS: A total of 35 patients were included: 10 with GBC, 14 with ICC, and 11 with PHC. There were 19 (54%) women and median age was 71 years. Median operative time was 240 min, and estimated blood loss was 200 ml. Conversion to an open procedure was more common in patients with PHC (45% vs. 7% for ICC and 0% for GBC, p = 0.010). R0 resection was achieved in 10 (100%), 12 (86%), and 8 (73%) patients in GBC, ICC, and PHC groups, respectively (p = 0.204). Postoperative morbidity was reported in 19 (54%) patients of whom 12 (34%) had minor complications. Postoperative mortality was reported in 4 (11%) patients; one (7%) in GBC group, one (7%) in ICC group, and two (18%) in PHC, p = 0.681. Median hospital stay was 11 days. CONCLUSIONS: The present series suggests that LLR is feasible in GBC, challenging but achievable in ICC but unsuitable for the moment in PHC.
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