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Adams et al. Mini-invasive Surg 2023;7:18 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2023.12

Review Open Access

Minimally invasive approaches to intrahepatic

cholangiocarcinoma

1
Alexandra M. Adams , Hop S. Tran Cao 2
1
Department of Surgery, Brooke Army Medical Center, San Antonio, TX 78234, USA.
2
Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Correspondence to: Dr. Hop S. Tran Cao, Department of Surgical Oncology, The University of Texas MD Anderson Cancer
Center, 1515 Holcombe Blvd, Houston, TX 77030, USA. E-mail: HSTran@mdanderson.org

How to cite this article: Adams AM, Tran Cao HS. Minimally invasive approaches to intrahepatic cholangiocarcinoma. Mini-
invasive Surg 2023;7:18. https://dx.doi.org/10.20517/2574-1225.2023.12

Received: 15 Feb 2023 First Decision: 6 Apr 2023 Revised: 4 May 2023 Accepted: 18 May 2023 Published: 26 May 2023

Academic Editors: Zenichi Morise, Giulio Belli Copy Editor: Dong-Li Li Production Editor: Dong-Li Li

Abstract
While the incidence of intrahepatic cholangiocarcinoma (ICC) is increasing, few patients are surgical candidates,
and recurrence rates remain high. Surgical resection remains the only potential curative therapy for ICC, and many
retrospective cohorts have demonstrated comparable short-term and long-term outcomes between open,
laparoscopic, and robotic liver resection (RLR) for ICC. However, rates of lymphadenectomy remain low amongst
all groups, especially in laparoscopic approaches, despite its role in prognostication and therapeutic management.
RLR may offer many of the short-term benefits of laparoscopic liver resection (LLR) and facilitate adequate
lymphadenectomy while also increasing the ability to access posterosuperior segments and perform major
hepatectomies.

Keywords: Intrahepatic cholangiocarcinoma, laparoscopic liver surgery, robotic liver surgery

INTRODUCTION
Intrahepatic cholangiocarcinoma (ICC) is the second most common primary liver malignancy after
hepatocellular carcinoma (HCC), and its incidence is increasing worldwide . While the only curative
[1-3]
therapy is surgical resection, only 15% of patients present with resectable disease . Even with surgical
[4,5]
resection, median survival ranges from 27 to 36 months, and disease recurrence will occur in two-thirds of
[6]
patients . In light of these statistics, systemic therapy is considered standard of care for all patients with

© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
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