腹腔镜肝门部胆管癌根治性切除术的临床疗效分析

Objective To analyze the feasibility and safety of laparoscopic radical resection of hilar cholangiocarcinoma (HCCA). Methods Clinical data of 72 patients with HCCA undergoing radical resection at the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Xi'an Jiaotong University from January 2019 to January 2022 were retrospectively analyzed, including 36 males and 36 females, aged 57(47, 63) years old. According to surgical approach, patients were divided into the laparoscopic group (n=39) and open group (n=33). The surgical safety, tumor radicality, postoperative recovery, complications and survival time were compared between the two groups. Results Operative time was comparable between the two groups [(6.4±2.6) h vs. (6.3±2.4) h, P>0.05], while the intraoperative blood loss was lower in the laparoscopic group [(531.9±273.3) ml vs. (674.6±330.0) ml]. Data were also comparable between the two groups in terms of R0 resection rate [92.3% (36/39) vs. 93.9% (31/33)], the number of lymph node dissection (7.7±2.6 vs. 7.6±2.4), and the incidence of postoperative complications [20.5% (8/39) vs. 18.2% (6/33)] (all P>0.05). However, the laparoscopic group was superior to the open group in terms of postoperative analgesia time [(2.0±0.7)d vs. (2.8±0.9)d], postoperative resumption of feeding time [(1.6±0.5)d vs. (3.9±0.9)d], and postoperative hospitalization time [(8.6±1.5)d vs. (12.8±2.2)d] (t=4.04, 8.23, 9.47, respectively, all P<0.001). Postoperative cumulative survival was comparable between the two groups (χ²=0.50, P=0.480). Conclusion Laparoscopic radical resection of HCCA has similar efficacy to open surgery and has the advantage of less invasiveness and enhanced recovery.