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Laparoscopic Left Hemihepatectomy Combined with Caudate Lobe Resection
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Total laparoscopic vs. open liver resection: comparative study with propensity score matching analysis.

Bruno Silva de Assis1, Fabricio Ferreira Coelho1, Vagner Birk Jeismann1

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Arquivos Brasileiros De Cirurgia Digestiva : ABCD = Brazilian Archives of Digestive Surgery
|May 20, 2020
PubMed
Summary

Total laparoscopic liver resection offers significant advantages over open surgery, including reduced operative time, shorter hospital stays, and fewer complications. This minimally invasive approach is safe and feasible for liver surgeries.

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Area of Science:

  • Hepatobiliary Surgery
  • Minimally Invasive Surgery
  • Surgical Oncology

Background:

  • Growing evidence supports minimally invasive liver surgery, but much data comes from biased retrospective studies.
  • Previous comparisons often group diverse minimally invasive techniques, limiting clarity.

Purpose of the Study:

  • To compare perioperative outcomes of total laparoscopic liver resection versus open liver resection.
  • Utilize propensity score matching (PSM) to minimize bias in patient selection.

Main Methods:

  • Included consecutive adult patients undergoing liver resection.
  • Constructed a PSM model using age, gender, diagnosis, hepatectomy type, and cirrhosis presence.
  • Matched patients 1:1 using the nearest method.

Main Results:

  • 120 patients per group after PSM.
  • Total laparoscopic liver resection showed significantly shorter operative times (286.8 vs. 352.4 min).
  • Laparoscopic approach resulted in shorter ICU (1.9 vs. 2.5 days) and hospital stays (5.8 vs. 9.9 days), with a 45% reduction in complications.

Conclusions:

  • Total laparoscopic liver resection is a safe and feasible approach.
  • Associated with improved perioperative outcomes, including reduced operative time and hospital stay.
  • Demonstrates a lower rate of perioperative complications compared to open surgery.