Laparoscopic vs. open liver resection for malignancies involving segment 7: short-term outcomes and learning curve...

Many studies demonstrated the feasibility of laparoscopic liver resection (LLR). However, its short-term outcomes for liver malignancies located in involving Couinaud's segment 7 have not been appraised compared to open liver resection (OLR). In addition, the impact of the LLR learning curve on surgical outcomes at these sites remains unclear.

This single-institution, retrospective study included 216 patients who underwent liver resection for malignancies involving segment 7 between 2010 and 2024. Propensity score matching balanced LLR (n = 65) and OLR (n = 65) cohorts. Surgical outcomes were compared and the LLR learning curve for conversions was plotted via risk-adjusted cumulative sum (RA-CUSUM) analysis.

LLR showed shorter postoperative hospital stays and a trend towards less blood loss. Despite longer operative times, LLR had lower postoperative white blood cell counts and similar alanine aminotransferase levels. There were no significant differences between the groups in the overall or severe complications. Moreover, RA-CUSUM analysis showed that after the surgeon completed around 30 patients, the conversion rate stabilized and improved, leading to enhanced safety.

LLR could act as a safe alternative to OLR in patients harboring malignancies involving segment 7, with accumulated experience contributing to improved outcomes.