Analysis of short-term treatment outcomes in intrahepatic cholangiocarcinoma using the textbook outcome model

Aim. To evaluate the frequency of achieving a textbook outcome (TO) after liver resection for intrahepatic cholangiocarcinoma.

Materials and methods. The present study considers results of intrahepatic cholangiocarcinoma surgery for 2015–2024. The achievement of the TO was assessed using criteria by B. Görgec et al. (2021): the absence of intraoperative complications of grade II and higher, Clavien–Dindo complications of grade III and higher, grade B and C bile fistula (ISGLS), hospital mortality, 30-day readmission, and R1 resection. The TO effect on survival was analyzed; the influence of factors on the achievement of the TO was assessed using the method of binary logistic regression.

Results. Of the 104 patients, the TO was achieved in 40 (38.5%). Factors significantly prevented the TO include the tumor size (p = 0.024), blood loss (p = 0.046), jaundice (p = 0.001), and open surgery (p = 0.010). The rate of TO achievement in ICC patients with liver resections without vascular and biliary reconstructions was 57.2%. The median overall survival for those who achieved and failed to achieve the TO was 53 and 27 months, respectively. No significant difference in disease-free (p = 0.483) and overall survival (p = 0.076) was observed, regardless of achieving the TO.

Conclusion. The introduction of an integrated TO model into clinical practice is an effective way to assess the quality and plan surgical treatment of patients with intrahepatic cholangiocarcinoma.

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