To evaluate the safety of laparoscopic radical resection of hilar cholangiocarcinoma based on propensity score matching (PSM).

Clinical data of 48 patients who underwent radical resection of hilar cholangiocarcinoma in the First Affiliated Hospital of Chongqing Medical University from January, 2016 to December, 2021 were retrospectively analyzed. Among them, 27 patients were male and 21 female, aged from 37 to 76 years, with a median age of 67 years. The informed consents of all patients were obtained and the local ethical committee approval was received. According to the surgical pattern, all patients were divided into the laparoscopic group (n=10) and open surgery group (n=38). After 1∶1 PSM, 10 patients were assigned into the laparoscopic group and 10 in the open surgery group. Perioperative conditions were compared between two groups. The operation time between two groups was compared by t test. Intraoperative blood loss, visual analogue scale (VAS) score at postoperative 1 d, and the length of postoperative hospital stay were compared by sum-rank test. Intraoperative blood transfusion rate and the incidence of severe complications were compared by Fisher's exact probability test.

After PSM, the average operation time in the laparoscopic and open surgery groups was (429±100) min and (364±97) min, and the difference was not statistically significant (t=1.484, P>0.05). In the laparoscopic and open surgery groups, the median intraoperative blood loss was 300(325) ml and 250(225) ml, the VAS scores at postoperative1 d were 2.5(2.0) and 3.0(1.0), and the length of postoperative hospital stay was 16(6) d and 18(8) d, and no significant difference was observed (Z=0.733, -0.457, -0.682; P>0.05). In the laparoscopic group, 3 patients received intraoperative blood transfusion and 1 in the open surgery group. No patient developed postoperative bile leakage in the laparoscopic group, and 1 case in the open surgery group, and no significant difference was observed (P=0.276, 0.371).

It is safe and feasible to perform laparoscopic radical resection of hilar cholangiocarcinoma for surgical teams with mature laparoscopic technique and intimate surgical cooperation. There is no significant difference in perioperative safety between laparoscopic and open surgeries.