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Updated: Dec 3, 2025
Laparoscopic Left Hemihepatectomy Combined with Caudate Lobe Resection
Published on: April 11, 2025
Minimally invasive versus open right hepatectomy: comparative study with propensity score matching analysis
Vinícius Campos Duarte1, Fabricio Ferreira Coelho2, Alain Valverde3
1Liver Surgery Unit, Digestive Surgery Division, Department of Gastroenterology, University of São Paulo School of Medicine, Rua Dr. Enéas de Carvalho Aguiar, 255-9º Andar-sala 9025, São Paulo, SP, CEP 05403-900, Brazil. viniciuscduarte@hotmail.com.
Minimally invasive right hepatectomies (MIRHs) offer significant benefits over open procedures, including reduced blood loss and fewer complications. This approach is safe and effective, demonstrating comparable long-term survival outcomes.
Area of Science:
- Hepatobiliary Surgery
- Minimally Invasive Surgery
- Surgical Outcomes
Background:
- Minimally invasive liver resections (MILRs) are gaining traction, but major hepatectomies remain technically demanding.
- This study addresses the challenge of performing major liver resections using a minimally invasive approach.
Purpose of the Study:
- To compare short- and long-term outcomes of minimally invasive right hepatectomies (MIRHs) versus open right hepatectomies (ORHs).
Main Methods:
- A comparative study of consecutive patients undergoing anatomic right hepatectomies between 2013 and 2018.
- Propensity score matching (PSM) was used to ensure group homogeneity for intention-to-treat analysis.
- Overall survival (OS) was analyzed for the entire cohort and specific etiologies.
Main Results:
- MIRHs demonstrated significantly lower blood loss (400ml vs. 500ml) and a reduced rate of minor complications (13.5% vs. 35%) compared to ORHs.
- Larger resection margins were achieved in the MIRH group (10mm vs. 5mm).
- No significant differences were observed in operative time, Pringle's maneuver use, overall morbidity, or perioperative mortality. Hospital stay was non-significantly shorter for MIRH (7 days vs. 9 days).
Conclusions:
- Minimally invasive right hepatectomies (MIRHs) are feasible and safe when performed by experienced surgeons.
- The minimally invasive approach is associated with reduced blood loss and fewer minor perioperative complications.
- MIRHs do not negatively impact long-term survival outcomes, with similar OS observed between MIRH and ORH groups.
