Long-Term Nononcologic Outcomes for Laparoscopic Liver Resection: Improvement over Open Hepatectomy?

Area of Science:

• Hepatobiliary Surgery
• Minimally Invasive Surgery
• Surgical Complications

Background:

• Long-term oncologic outcomes of laparoscopic liver resection (LLR) are well-studied.
• Non-oncologic, long-term complications following LLR require further investigation.
• Comparing LLR to open liver resection (OLR) for these outcomes is essential.

Purpose of the Study:

• To analyze and compare long-term, non-disease-specific complications between LLR and OLR.
• To identify risk factors associated with long-term complications after liver resection.

Main Methods:

• Retrospective review of patients undergoing liver resection (2005-2014).
• Defined long-term complications as those occurring >90 days post-surgery, excluding disease recurrence.
• Focused analysis on incisional hernia (IH) and small bowel obstruction (SBO).

Main Results:

• Fewer patients developed IH after LLR (7.5%) compared to OLR (19.6%) (P=0.01).
• No cases of SBO were observed after LLR, versus 3.4% after OLR.
• Independent risk factors for long-term complications included male gender, higher BMI, prior abdominal surgery, and OLR.

Conclusions:

• LLR is associated with a lower incidence of long-term, non-disease-specific complications than OLR.
• Open liver resection is a significant risk factor for developing long-term complications such as IH and SBO.