Comparison of Short-term Outcomes in Laparoscopic vs Open Hepatectomy

Abstract

Patients who undergo LH have similar short-term outcomes when compared with those who undergo OH. Laparoscopic hepatectomy was associated with lower intraoperative blood loss, although the clinical significance of this finding is uncertain given the lack of difference in perioperative transfusion or morbidity rates. In addition, we found no difference in margin status between the 2 groups. Future studies are needed to define which patients derive benefit from LH and to determine oncologic equivalence to OH.

EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma

“…With respect to size, anatomic resections should be preferred for HCC nodules of at least 2 cm in size, 350 with a very large retrospective series 351 and newer less invasive laparoscopic-resections questioning the superiority of anatomic LR in HCC of larger size. [352][353][354] Limited resections conducted through laparoscopic-robotic techniques in large volume centres are feasible and indicated for curative LR in selected groups of HCC with borderline liver conditions (i.e. Child B7, moderate PH or bilirubin around 2 mg/dl) and several studies have demonstrated that laparoscopic-robotic resections of HCC in cirrhosis are associated with reduced risk of post-operative liver decompensation.…”

Propensity score analysis of outcomes following laparoscopic or open liver resection for hepatocellular carcinoma

“…In fact, primary liver cancer currently represents the main indication for LLR among malignancies, with more than 500 procedures reported since 2000. Despite a large amount of data showing encouraging results in favour of this technique, the superiority of LLR in terms of perioperative outcomes has not been proven definitively. The same applies to long‐term outcomes, which hitherto have been assessed poorly in small retrospective or case‐matched series.…”

Current advances in liver surgery

“…[29] These results also echoed with the latest systematic review and meta-analysis by Yin et al [30] Despite numerous studies showing the short-term benefits of LLR, the decrease in complications was not universally observed among the studies. In the latest retrospective matched case-control study by Franken et al, [31] last year, the advantages were modest. Although there was a reduction in blood loss, there was no difference in transfusion requirement.…”