To investigate the clinical efficacy of percutaneous ablation and laparoscopic hepatectomy in the treatment of early intrahepatic cholangiocarcinoma (ICC) with single lesion ≤3 cm.

A total of 68 patients with early ICC admitted from January 2020 to December 2023 were prospectively enrolled and randomly divided into the laparoscopic hepatectomy (LH) group and radiofrequency ablation (RFA) group using a random number table, with 34 cases in each group. The LH group received laparoscopic hepatectomy, while the RFA group underwent percutaneous radiofrequency ablation. Data were analyzed using SPSS 27.0 statistical software. Measurement data such as operation time and intraoperative blood loss were expressed as (±s) and compared using independent sample t tests. Enumeration data such as postoperative complication grades and overall survival rate were expressed as percentages and analyzed using χ² test or Z test. Survival curves were drawn by Kaplan-Meier method, and intergroup survival relationships were tested by Log-Rank test.

The operation time, intraoperative blood loss, time to first feeding, time to ambulation, hospital stay, and hospitalization cost in the RFA group were all lower than those in the LH group (P<0.05). The total incidence of postoperative complications in the RFA group was lower than that in the LH group (11.8% vs. 44.1%, P>0.05). There were no statistically significant differences in disease-free survival rate and overall survival rate between the two groups within 3 years after surgery (Log-Rank χ² disease-free=0.110, P disease-free=0.947; Log-Rank χ² overall survival=0.042, P overall survival=0.979).

For patients with early ICC, RFA treatment ensures comparable disease-free survival and overall survival rates, with shorter operation time, less intraoperative blood loss, faster postoperative recovery, lower surgical cost, and a lower incidence of postoperative complications.