Minimally invasive surgical treatment of intrahepatic cholangiocarcinoma: A systematic review

Table 1 Study characteristics and quality assessment

Ref.	Country	Type of study		LS	OS	NOS			Minors
						Selection	Comparability	Outcame/Exposure
Wu et al[28], 2020	China	RetS-SC	Case control study	18	25	***	*	***	17
Haber et al[27], 2020	Germany	RetS-SC	Case control study	27	31	***	*	**	16
Kang et al[26], 2020	Korea	RetS-SC	Propensity score matching	30	61	***	**	***	18
Kinoshita et al[24], 2020	Japan	RetS-SC	Case control study	15	21	***	**	***	18
Ratti et al[25], 2020	United Kingdom-Italy	RetS-TC	Propensity score matching	104	104	***	**	***	19
Martin et al[23], 2019	United States	RetS-DB	Database	312	1997	**	*	**	15
Zhu et al[22], 2019	China	RetS-SC	Propensity score matching	20	63	***	**	***	19
Wei et al[21], 2017	China	RetS-SC	Case control study	30	20	***	**	***	19
Lee et al[20], 2016	Korea	RetS-SC	Case control study	14	23	***	**	***	20

LS: Number of patients treated with laparoscopic surgery; OS: Number of patients treated with open surgery; NOS: Newcastle-Ottawa Scale for assessing the quality of nonrandomised studies.A study can be awarded a maximum of one star (*) for each numbered item within the selection and exposure categories. A maximum of two stars can be given for comparability. MINORS: Methodological index for non-randomized studies; RetS: Retrospective study; SC: Single center; TC: Two centres; DB: Data base.

Table 2 Preoperative and surgical data

Ref.	SA	NP	AGE	ASA				MayorH	Lymphadenectomy		OT	IOBL	CONV.
				I	II	III	IV		Yes	Number
Wu et al[28], 2020	OS	25	61	19		6		13 (52%)	6 (32%)	6	300 (257-392)	500 (350-750)	N/A
	LS	18	64	15		3		6 (33%)	8 (33%)	6	305 (207-390)	375 (275-500)	0
Haber et al[27], 2020	OS	31	63	1	21	8	1	24 (78%)	29 (94%)	8	282 (112–947)	/	N/A
	LS	27	69	0	15	12	0	19 (70%)	23 (85%)	8	314 (125–439)	/	2
Kang et al[26], 2020	OS	61	68	/	/	/	/	53 (88.3%)	46 (75.4%)	/	343.2 ± 106.0	979.3 ± 864.4	N/A
	LS	30	65	/	/	/	/	20 (66.7%)	9 (30%)	/	375.2 ± 204.0	1396.7 ± 2568.9	6
Kinoshita et al[24], 2020	OS	21	68	/	/	/	/	15	7 (33%)	3	358 (150-634)	500 (105-3710)	N/A
	LS	15	65	/	/	/	/	5	6 (40%)	2	360 (221-802)	150 (20-2500)	0
Ratti et al[25], 2020	OS	209	62	20	58	26	0	38 (36.5%)	92 (88.5%)	7 (5–14)	230 ± 60	350 ± 250	N/A
	LS	114	60	22	56	26	0	35 (33.7%)	87 (83.7%)	8 (5–11)	270 ± 65	150 ± 100	0
Martin et al[23], 2019	OS	1997	64	/	/	/	/	1338 (67%)	1210 (61.2%)	/	/	/	N/A
	LS	312	65	/	/	/	/	137 (44%)	312 (38.5%)	/	/	/	/
Zhu et al[22], 2019	OS	63	56	/	/	/	/	43 (68.3%)	27 (42.9%)	/	200 (140–320)	400 (50–2000)	N/A
	LS	20	54	/	/	/	/	11 (55%)	8 (40%)	/	225 (140–400)	200 (50–1000)	2
Wei et al[21], 2017	OS	20	60.5	/	/	/	/	11 (55%)	11 (55%)	/	230 (125–420)	350 (50–1200)	N/A
	LS	12	61.5	/	/	/	/	7 (58.3%)	4 (33%)	/	212.5 (60–500)	350 (30–2000)	0
Lee et al[20], 2016	OS	23	59	0	20	2	1	19 (82.6%)	15 (65.2%)	6 (1–16)	330.0 (140–590)	625 (250–2500)	N/A
	LS	14	66	0	12	2	0	7 (50%)	5 (35.7%)	4 (1–12)	255.0 (140–480)	325 (10–1500)	0

Results for each Author are represented divided in two lines: Open surgery and laparoscopic surgery. LS: Laparoscopic surgery; OS: Open surgery; SA: Surgical approach; NP: Number of patients; Age are expressed in year; ASA: American Society of Anaesthesiologists physical status classification; MajorH: Major hepatectomy considered as equal or more than 3 resected segments; OT: Operation time expressed in minutes; IOBL: Intra-operative blood loss expressed in mL; Conv: Number of procedure converted from laparoscopic to open approach. In bold differences with a P value < 0.05.

Table 3 Post-operative and oncological data

Ref.	SA	ICUS	HS	HM		30-d morbidity		90-d morbidity	mFU	OS	DFS
				R0	R1	Grade I-II	Grade III-IV
Wu et al[28], 2020	OS	/	9 (7-15)	/	/	23	2	1	/	20	4
	LS	/	6 (5-12)	/	/	17	1	0	/	47.1	0
Haber et al[27], 2020	OS	1 (0–6)	12 (5–33)	23	8	8	10	0	/	/	/
	LS	1 (0–81)	10 (3–94)	24	3	3	5	2	/	/	/
Kang et al[26], 2020	OS	/	18.3 ± 14.7	/	/	/	23	0	16.8	81.2	42.5
	LS	/	9.8 ± 5.1	/	/	/	8	0	39.2	76.7	65.6
Kinoshita et al[24], 2020	OS	/	/	20	1	/	4	/	/	36	19
	LS	/	/	14	1	/	2	/	/	32	24
Ratti et al[25], 2020	OS	4 (3–10)	6 (3–21)	99	5	17	8	2	50	47	34
	LS	3 (1–5)	4 (2–10)	101	3	11	4	1	39	46	36
Martin et al[23], 2019	OS	/	/	1451	546	/	/	/	/	/	/
	LS	/	/	247	65	/	/	/	/	/	/
Zhu et al[22], 2019	OS	/	7 (3–33)	58	5	22	6	0	24	17	32
	LS	/	6 (3–9)	19	1	3	1	0	24	21	31
Wei et al[21], 2017	OS	/	11 (5–30)	19	2	10	3	0	12	32.7	27.9
	LS	/	14 (6–23)	12	0	3	2	0	17.5	56.3	43.8
Lee et al[20], 2016	OS	/	20 (9–63)	/	/	1	4	0	/	75.7	/
	LS	/	15 (9–29)	/	/	0	3	0	/	84.6	/

Results for each Author are represented divided in two lines: Open surgery and laparoscopic surgery. LS: Laparoscopic surgery; OS: Open surgery; SA: Surgical approach; ICUS: Intensive care unit stay in days; HS: Hospital stay in days; HM: Histopathological margins; mFU: Median follow-up in months; OS: Overall survival expressed in months after surgery; DFS: Disease-free survival expressed in months after surgery. In bold differences with a P value < 0.05.