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Updated: Mar 17, 2026
Laparoscopic Anterior Right Hepatectomy: A Single-Center Experience
Published on: December 4, 2023
Minimally Invasive vs. Open Hepatectomy: a Comparative Analysis of the National Surgical Quality Improvement Program
Fabio Bagante1, Gaya Spolverato1, Steven M Strasberg2
1Department of Surgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Blalock 688, Baltimore, MD, 21287, USA.
Background:
While minimally invasive surgery (MIS) to treat liver tumors has increased, data on perioperative outcomes of MIS relative to open liver resection (O-LR) are lacking. We sought to compare short-term outcomes among patients undergoing MIS vs. O-LR in a nationally representative database.
Methods:
The National Surgical Quality Improvement Program database was used to identify patients undergoing hepatectomy between January 1 and December 31, 2014. Propensity score matching algorithm was used to balance differences in baseline characteristics among MIS and O-LR groups.
Results:
A total of 3064 patients were included in the study. After propensity matching, the baseline characteristics for O-LR and MIS groups were comparable (minimum p value = 0.12). Incidence of superficial surgical site infections, intraoperative or postoperative blood transfusions, and pulmonary embolism was lower among patients in MIS group compared to O-LR (p < 0.02). Liver failure and biliary leakage were also less frequent among patients undergoing MIS (p < 0.01). Similarly, MIS was associated with a shorter length of hospital stay (LOS) compared to O-LR (p < 0.001). Of note, 30-day postoperative mortality and readmission were comparable between the two groups.
Conclusions:
Patients undergoing MIS had a lower postoperative morbidity and shorter LOS compared with patients undergoing O-LR. MIS is safe and may be associated with improved short-term outcomes following hepatic surgery.
Insights
Minimally invasive surgery (MIS) for liver tumors shows improved outcomes compared to open liver resection (O-LR). MIS is linked to fewer complications and shorter hospital stays, demonstrating its safety and potential benefits.
Area of Science:
- Hepatobiliary surgery
- Surgical oncology
- Minimally invasive surgical techniques
Background:
- Minimally invasive surgery (MIS) for liver tumors is increasing.
- Limited data exists on perioperative outcomes comparing MIS to open liver resection (O-LR).
Purpose of the Study:
- To compare short-term perioperative outcomes between MIS and O-LR for liver tumors.
- To evaluate the safety and efficacy of MIS in liver resections.
Main Methods:
- Utilized the National Surgical Quality Improvement Program database (2014).
- Included patients undergoing hepatectomy.
- Employed propensity score matching to balance baseline characteristics between MIS and O-LR groups.
Main Results:
- Superficial surgical site infections, blood transfusions, and pulmonary embolism were lower in the MIS group (p < 0.02).
- Liver failure and biliary leakage were less frequent in MIS patients (p < 0.01).
- MIS was associated with a significantly shorter length of hospital stay (LOS) (p < 0.001).
- 30-day postoperative mortality and readmission rates were comparable between groups.
Conclusions:
- Patients undergoing MIS experienced lower postoperative morbidity and shorter LOS compared to O-LR.
- MIS appears to be a safe approach for hepatic surgery, potentially offering improved short-term outcomes.
