Comparison of efficacy of two surgical resection methods for hilar cholangiocarcinoma: A systematic review

ABSTRACT

Objective: To systematically analyze the prognosis of limited hilar hepatectomy versus combined liver lobectomy in the treatment of hilar cholangiocarcinoma. Methods: We searched CBM, CNKI, VIP, Wangfang, PubMed, SCI, Elsevier clinicalkey and OVID, and the cut-off time of searching was 31 April, 2019. Two researchers evaluated the risk of bias of the included studies independently according to the Newcastle-Ottawa Scale (NOS), and extracted data. RevMan 5.3 software was used for meta-analysis. Results: A total of 12 cohort studies involving 1 288 patients were included, of which 426 patients were in the limited hilar hepatectomy group and 862 patients in the combined liver lobectomy group. Meta-analysis showed that there were statistically significant difference in radical resection rate and postoperative complication rate (RR=0.55, 95%CI 0.40 to 0.74, P<0.001; RR=0.63, 95%CI 0.49 to 0.81, P<0.001) between the hilar limited hepatectomy group and the combined liver lobectomy group; significant differences were found in 1-, 2- and 3-year survival rates (RR=0.75, 95%CI 0.67 to 0.84, P<0.001; RR=0.55, 95%CI 0.42 to 0.74, P<0.001; RR=0.54, 95%CI 0.39 to 0.75, P<0.001) between the two groups. Conclusions: Comparing with the limited hilar hepatectomy, the radical resection rate of combined liver lobectomy was higher, and the 1-, 2- and 3-year survival rates were improved, but the complications was increased in treatment of hilar cholangiocarcinoma.