腹腔镜下肝内胆管细胞癌切除术的短期和长期结果

M. Efanov, R. Alikhanov, I. Kazakov, N. Britskaia, Y. Kulezneva, O. Melekhina, A. Vankovich, A. Koroleva, N. Kulikova, E. Zamanov, V. Tsvirkun, I. Khatkov
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引用次数: 0

摘要

目标评估腹腔镜和开放式手术治疗肝内胆管细胞癌的短期和长期效果。材料和方法。本文介绍了53名患者(2015-2020年)腹腔镜和开放式肝脏切除术的回顾性研究结果。腹腔镜手术的患者选择包括保持进行R0切除术的可能性。由于排除了切除以及血管和胆管重建,在对各组进行排列之前和之后,就切除的复杂性进行了比较。后果手术53例;19例患者行腹腔镜切除术。在开放组中,血管和胆管的切除和重建明显更频繁。腹腔镜组严重并发症和胆汁渗漏的发生率显著降低,但不影响住院时间。在消除了切除复杂性的差异后,比较显示腹腔镜组的出血量和胆道并发症较低,R0切除率较高。在切除复杂性方面,调整前后两组的总生存率和无复发的四年生存率没有差异。结论首次使用腹腔镜入路治疗肝内胆管细胞癌的经验表明,在不恶化短期和长期肿瘤学结果的情况下,可以提高治疗的即时效果。
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Short- and long-term outcomes of laparoscopic resections for intrahepatic cholangiocellular carcinoma
Aim. To evaluate short- and long-term results of laparoscopic and open surgeries for intrahepatic cholangiocellular carcinoma.Materials and Methods. The paper presents the retrospectively studied results of laparoscopic and open liver resections in 53 patients (2015–2020). The selection of patients for laparoscopic surgery consisted in maintaining the possibility of performing an R0 resection. A comparison was made before and after the alignment of the groups in relation to the complexity of resection due to the exclusion of resections and the reconstructions of vessels and bile ducts.Results. 53 patients were operated on; 19 patients underwent laparoscopic resection. In the open group, resection and reconstruction of vessels and bile ducts were performed significantly more often. A significantly lower incidence of severe complications and bile leakage was noted in the laparoscopic group, which did not affect the duration of hospital stay. After eliminating the differences in resection complexity, the comparison showed lower blood loss and biliary complications as well as a higher R0 resection rate in the laparoscopic group. The overall and recurrence-free four-year survival did not differ in the groups before and after aligning in terms of resection complexity.Conclusion. The first experience of using laparoscopic access for intrahepatic cholangiocellular carcinoma indicates that it is possible to improve the immediate results of treatment without worsening short- and long-term oncological outcomes.
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来源期刊
Annals of HPB Surgery
Annals of HPB Surgery Medicine-Gastroenterology
CiteScore
0.70
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0.00%
发文量
41
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