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International multicenter propensity score matched study on laparoscopic versus open left lateral sectionectomy
Marcel J van der Poel1, Robert S Fichtinger2, Burak Gorgec1
1Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Summary
Laparoscopic left lateral sectionectomy (LLLS) offers significant advantages over open LLS (OLLS), including shorter operative times, reduced blood loss, and quicker hospital recovery. This validates current guidelines favoring the laparoscopic approach.
Area of Science:
- Hepatobiliary surgery
- Minimally invasive surgical techniques
- Surgical outcomes research
Background:
- Current guidelines recommend laparoscopic left lateral sectionectomy (LLLS) over open LLS (OLLS) despite limited high-level evidence.
- A need exists for comparative studies, particularly propensity score-matched analyses, evaluating LLS versus OLLS for all indications, including malignancy.
Purpose of the Study:
- To compare short-term operative outcomes between laparoscopic left lateral sectionectomy (LLLS) and open left lateral sectionectomy (OLLS).
- To provide evidence supporting current guideline recommendations for LLLS.
Main Methods:
- International multicenter retrospective cohort study (January 2000-December 2016).
- Propensity score matching (1:1 ratio) based on nine preoperative variables for 200 LLLS and 139 OLLS patients.
- Comparison of short-term operative outcomes using paired tests.
Main Results:
- LLLS demonstrated significantly shorter operative times (144 vs. 199 minutes, P < 0.001).
- LLLS was associated with less blood loss (100 vs. 350 mL, P = 0.005).
- LLLS resulted in a 3-day shorter postoperative hospital stay (4 vs. 7 days, P < 0.001).
Conclusions:
- This propensity score-matched study confirms the superiority of LLLS over OLLS.
- Findings support current guideline recommendations for routine use of LLLS.
- LLLS offers improved operative efficiency and patient recovery compared to OLLS.
