title: Laparoscopic liver resection for intrahepatic cholangiocarcinoma.
abstract: BACKGROUND
  Reports on laparoscopic liver resection for intrahepatic cholangiocarcinoma are still scarce. With increased experience in laparoscopic liver resection, its application to intrahepatic cholangiocarcinoma can now be considered. Our aim is to determine the feasibility and safety of laparoscopic liver resection for intrahepatic cholangiocarcinoma and to analyze its clinical and oncologic outcomes.
  
  
  METHODS
  Among the 84 patients with intrahepatic cholangiocarcinoma operated on from March 2004 to April 2012, 37 patients with a T-stage of 2b or less were included in the study. Eleven patients underwent laparoscopic liver resection, and 26 underwent open liver resection. Treatment and survival outcomes were analyzed.
  
  
  RESULTS
  Intraoperative blood loss was significantly greater in the open group (P=.024), but with no difference in the blood transfusion requirement between groups (P=.074), and no operative mortality occurred. The median operative time, postoperative resection margin, and length of hospital stay were comparable between groups (P=.111, P=.125, and P=.077, respectively). Four (36.4%) patients in the laparoscopic group developed recurrence compared with 12 (46.2%) patients in the open group (P=.583). After a median follow-up of 17 months, the 3- and 5-year overall survival rates were 77.9% and 77.9%, respectively, in the laparoscopic group compared with 66.2% and 66.2%, respectively, in the open group (P=.7). There was also no significant difference in the 3- and 5-year disease-free survival rates for the laparoscopic group at 56.2% and 56.2%, respectively, versus the open group at 39.4% and 39.4%, respectively (P=.688).
  
  
  CONCLUSIONS
  Laparoscopic liver resection for intrahepatic cholangiocarcinoma is technically safe with survival outcome comparable to that of open liver resection in selected cases.
authors: Department of Surgery, Seoul National University Bundang Hospital , Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, Republic of Korea.
authors: Billy James
authors: BJ
authors: Uy
authors: Ho-Seong
authors: HS
authors: Han
authors: Yoo-Seok
authors: YS
authors: Yoon
authors: Jai Young
authors: JY
authors: Cho
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000401:mortality / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000601:surgery*; D018281:Cholangiocarcinoma / Q000401:mortality / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome