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NATIONAL TRENDS IN SURGERY FOR INTRAHEPATIC CHOLANGIOCARCINOMA: 2004-2014
Jairo Espinosa^*, Ransome Eke, Gitonga Munene
SURGERY, WESTERN MICHIGAN HOMER STRYKER SCHOOL OF MEDICINE, KALAMAZOO, MI
Background: Intrahepatic cholangiocarcinoma (IHC) is a malignancy with an increasing incidence. The only potentially curative option for patients with resectable disease is surgery. The objective of this study was to determine the overall use and temporal trends of surgery for patients with IHC using a nationally representative cohort.
Methods: Hospital discharge data in the United States from 2004 to 2014, was analyzed using the National Inpatient Sample data compiled by the Healthcare Cost and Utilization Project (HCUP). Trends of different surgical procedures performed on patients with IHC were summarized. Using billing procedure codes, the surgical procedures were analyzed.
Results: During the study period a total of 22, 662 persons were diagnosed with IHC, with a nearly 2-fold increase from 2.36 per 100,000 (95% CI, 2.03-2.69) in 2004 to 4.38 per 100,000 (95% CI, 4.10-4.67) in 2014. There was a total of 7,590 (95% C.I.; 6773 - 8407) surgical procedure performed among patients with IHC from years 2004 to 2014. The median age of patients who had procedure was 66 years (Interquartile rage (IQR); 57- 76). The number of procedures increased from 412 to 1055 (p<0.05) with greater than 90% being resections. During the time period there was a reduction in mortality and length of stay p<0.05.
Conclusions: There has been a concordant increase in surgery for IHC with the increasing incidence of IHC. During the study period there was an improvement in mortality and length of stay.

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