Evaluation of the outcomes of staging laparoscopy in intrahepatic cholangiocarcinoma patients undergoing surgical resection: a multicenter retrospective study in China

Aim: To evaluate the perioperative outcomes and postoperative survival of applying staging laparoscopy (SL) in intrahepatic cholangiocarcinoma (ICC) patients undergoing surgical resection. Methods: A retrospective analysis was performed on all selected ICC patients who underwent curative-intent resection with/without applying staging laparoscopy from January 2010 to August December 2021. Perioperative outcomes and postoperative survival were analyzed. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were performed to reduce the bias due to confounding variables in the SL group and the non-SL group. Multivariate Cox analysis was used to ascertain the independent predictor of survival for ICC patients. Results: A total of 279 patients (24.1%) were included in the SL group, while 881 patients (75.9%) were included in the non-SL group. Compared with the non-SL group, the SL group had lower blood loss, smaller tumor size, higher R0 resection rate, and shorter hospital stay, but a higher incidence of postoperative complications. The OS of the SL group was better than that of the non-SL group (Median OS: 31 months vs. 20 months). The 1-, 3-, and 5-year overall survival rates of the SL group were 77.9%, 45.1%, and 32.9%, respectively, while the non-SL group had rates of 63.9%, 31.3%, and 18.4%. SL was confirmed as an independent predictor of survival by multivariate Cox analysis. Conclusion: ICC patients receiving SL had better perioperative outcomes and significantly prolonged overall survival after resection surgery. The subgroup analysis results support the use of routine SL.