Abstract
Background To describe our preliminary experience in the procedure of laparoscopic radical resection of hilar cholangiocarcinoma and evaluate its feasibility, safety, and clinical effect.Methods Retrospectively summarized the 44 patients with hilar cholangiocarcinoma who underwent laparoscopic surgery in our hospital from August 2019 to September 2023. Collected the clinical data of those patients, including 13 cases of Bismuth typeⅠ,17 cases of Bismuth type Ⅱ, 5 cases of Bismuth type Ⅲa, and 9 cases of Bismuth type Ⅲb.Results Laparoscopic radical resection of hilar cholangiocarcinoma was ultimately performed in 38 (86.3%) patients, of the remaining patients, 3 patients required vascular reconstruction in order to complete radical surgery and thus convert to laparotomy, and other 3 patients underwent T-tube drainage only due to unresectable metastases. The median operation time was 285 min (range, 190–450). The median estimated blood loss was 360 mL (range, 260–1200). The length of postoperative stay was 14.3 ± 3.6 days. There was no death case during the perioperative period. The postoperative pathological examination showed negative microscopic margin (R0) in 39 cases, and positive microscopic margin (R1) in 2 cases. Postoperative complications occurred in 8 patients (18.1%), 4 cases (9.0%) of Grade I, 3 cases (6.8%) of Grade II, 1 case (2.2%) of Grade III, and no Grade Ⅳ complications. The median overall survival for patients who underwent radical R0 resection was 30.4 months (range, 5.3–43.6). The overall survival rate was 73.6% at 1 year, 61.2% at 2 years, and 40.1% at 3 years.Conclusion Total laparoscopic radical resection of hilar cholangiocarcinoma is safe, feasible, and effective if performed by an experienced surgeon after accurate preoperative evaluation.