Published online Dec 15, 2021. doi: 10.4251/wjgo.v13.i12.2203
Peer-review started: March 23, 2021
First decision: May 3, 2021
Revised: May 30, 2021
Accepted: October 31, 2021
Article in press: October 31, 2021
Published online: December 15, 2021
Processing time: 266 Days and 6 Hours
Intrahepatic cholangiocarcinoma represents a very aggressive tumor with poor prognosis. Nowadays surgical open approach is still the gold standard treatment but minimally invasive surgery is gaining an important role. No randomized trials are available on this topic in scientific literature.
Our scientific group aim to contribute to the development of the scientific research on hepatobiliary minimally invasive surgery.
Our research had the objective to summarize and review the scientific evidences present in the literature on minimally invasive surgical approach for intrahepatic cholangiocarcinoma.
We performed a systematic review of the literature between 01/01/2009 and 01/01/2021. Our research keywords were: "cholangiocarcinoma", "intrahepatic", "laparoscopic", "surgery", "minimally invasive", "robotic surgery" "biliary neoplasm", "liver resection" and "hepatectomy”. We selected only papers comparing open and laparoscopic approach and reporting at least one intraoperative, postoperative or oncological outcomes.
We found 9 papers that fulfilled all inclusion criteria reporting data from 3012 patients with no differences in baseline characteristic. Almost all operative outcomes were in favor of laparoscopic groups (blood losses, operative time, hospital stay, post-operative complications) except for the number of lymphonodes retrieved (higher number of lymphonodes retrieved in the open groups). No statistical differences in oncological outcomes were reported.
Our research demonstrates that very few studies investigated the role of minimally invasive surgery for intrahepatic cholangiocarcinoma. Currently available data in the Literature were not consistent enough to consider the laparoscopic approach to ICC as a standard of care but a steady implementation is likely to be realized in the next future.
It is likely that soon the diffusion of robotic surgery and tailored surgery, will promote the diffusion of minimally invasive approach for intrahepatic cholangiocarcinoma and will help elucidating its role and the oncological outcomes.