Division of Hepatobiliary and Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, China.
Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
Biosci Trends. 2020 Jul 17;14(3):168-173. doi: 10.5582/bst.2020.03010. Epub 2020 May 9.
Our purpose was to explore the status of laparoscopic radical resection of hilar cholangiocarcinoma (LRRHcca) in Mainland China. Studies published before February 2020 were retrieved from CNKI database, Pubmed database and Wanfang database. Search terms included "hilar cholangiocarcinoma", "Klatskin tumor", "laparoscopy", "radical operation". Relevant articles regarding LRRHcca in Mainland China were also retrieved. 13 articles were included in this study, with a total of 189 cases. The operation time was 354 min (weighed average, WA), and the mean intraoperative blood loss was 324 mL (WA). The rate of negative margin (R0 rate) was 95.2%, and the number of lymph nodes received was 9.5 (WA). 2.6% of cases were converted to laparotomy. The incidence of postoperative complications was 21.2%, with 3.2% for those classified as Clavien-Dindo ≥ 3, 12.2% for bile leakage, 1.6% for postoperative abdominal hemorrhage, 1.6% for liver insufficiency, and 1.1% for abdominal infection. In-hospital mortality was 0.5%, with mean postoperative hospital stay of 15 days (WA), and the rate of reoperation was 1.1%. The mean postoperative follow-up time was 16 months (WA), and 1-year overall survival rate was 84.5%. In conclusions, laparoscopic radical hilar cholangiocarcinoma is safe and feasible in experienced hands after careful selection of HCCA cases.
我们的目的是探讨中国大陆地区腹腔镜肝门部胆管癌根治术(LRRHcca)的现状。检索中国知网(CNKI)数据库、PubMed 数据库和万方数据库中 2020 年 2 月前发表的研究,检索词包括“肝门部胆管癌”“Klatskin 肿瘤”“腹腔镜”“根治性手术”。还检索了中国大陆地区有关 LRRHcca 的相关文章。共纳入 13 篇文章,共计 189 例。手术时间为 354 分钟(均数,WA),术中平均出血量为 324 毫升(WA)。阴性切缘率(R0 率)为 95.2%,清扫淋巴结数为 9.5(WA)。2.6%的病例中转开腹。术后并发症发生率为 21.2%,其中 Clavien-Dindo 分级≥3 级的为 3.2%,胆漏为 12.2%,术后腹腔出血为 1.6%,肝功能不全为 1.6%,腹腔感染为 1.1%。住院死亡率为 0.5%,术后平均住院时间为 15 天(WA),再次手术率为 1.1%。术后平均随访时间为 16 个月(WA),1 年总生存率为 84.5%。总之,在经验丰富的医生的精心选择下,腹腔镜肝门部胆管癌根治术在 HCCA 病例中是安全可行的。