Short- and long-term outcomes after laparoscopic and open liver resection for combined hepatocellular-cholangiocarcinoma patients: a propensity score-matched study.

[BACKGROUND] The feasibility and safety of laparoscopic liver resection (LLR) and open liver resection (OLR) in combined hepatocellular-cholangiocarcinoma (cHCC-CCA) patients remain controversial. This study compared the clinical outcomes of LLR versus OLR for patients with cHCC-CCA.

[METHODS] Clinicopathological features of cHCC-CCA patients who underwent liver resection (LR) between 2010 and 2022 were retrospectively analyzed. Propensity score matching (PSM) was employed to balance intergroup differences. Univariate and multivariate Cox analyses were employed to identify independent predictors of overall survival (OS).

[RESULTS] Of the 141 cHCC-CCA patients, 78 underwent LLR and 63 underwent OLR. After PSM, the LLR group had lower estimated blood loss (EBL) (200 . 300 mL, P=0.004) and shorter postoperative length of stay (LOS) (10.0 . 15.0 days, P<0.001). Multifactor Cox regression analyses showed that hepatocellular carcinoma (HCC) as the tumor main ingredient [hazard ratio (HR) =0.323, 95% confidence interval (CI): 0.151-0.693, P=0.004] was an independent protective factor for OS. After PSM, no statistically significant difference in OS was observed between the two groups (60.0 . 69.0 months, P=0.54).

[CONCLUSIONS] cHCC-CCA patients undergoing LLR are safe and feasible with lower EBL, and shorter postoperative LOS. No statistically significant difference in long-term OS was observed between LLR and OLR.