Laparoscopic versus open major hepatectomy: a systematic review and meta-analysis of individual patient data

Kasai, Meidai; Cipriani, Federica; Gayet, Brice; Aldrighetti, Luca; Ratti, Francesca; Sarmiento, Juan M.; Scatton, Olivier; Kim, Ki‐Hun; Dagher, Ibrahim; Topal, Baki; Primrose, John; Nomi, Takeo; Fuks, David; Hilal, Mohammed Abu

doi:10.1016/j.surg.2018.01.020

Cited by 160 publications

(142 citation statements)

References 46 publications

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“…Laparoscopic surgery for hepatobiliary‐pancreatic surgery has also spread quickly over the last decade, with the optimization of procedures and good selection criteria depending on tumor location contributing to improved effectiveness and safety . The merits of laparoscopic surgery in liver resection are thought to be the magnified view and reduced invasiveness of the operation . Compared to open liver resection, in recent reports, less blood loss from the hepatic veins during liver transection contributes to better surgical outcomes with laparoscopic surgery …”

Section: Laparoscopic Liver Resectionmentioning

confidence: 99%

Current topics in liver surgery

Yamazaki

Takayama

2019

Annals of Gastroent Surgery

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Liver resection is one of the main treatment strategies for liver malignancies. Mortality and morbidity of liver surgery has improved significantly with progress in selection criteria, development of operative procedures and improvements in perioperative management. Safe liver resection has thus become more available worldwide. We have identified four current topics related to liver resection (anatomical liver resection, laparoscopic liver resection, staged liver resection and chemotherapy‐induced liver injury). The balance between treatment effect and patient safety needs to be considered when planning liver resection. Progress in this area has been rapid thanks to the efforts of many surgeons, and outcomes have improved significantly as a result. These topics remain to be solved and more robust evidence is needed. Precise selection of the optimal procedure and risk evaluation should be standardized with further development of each topic. The present article reviews these four current topics with a focus on safety and efficacy in recent series.

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Section: Laparoscopic Liver Resectionmentioning

confidence: 99%

Current topics in liver surgery

Yamazaki

Takayama

2019

Annals of Gastroent Surgery

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“…Laparotomy has long been the preferred surgical approach but laparoscopic liver resection (LLR) is gaining popularity. Advantages of LLR include a quicker recovery and reduced morbidity leading to the consensus that laparoscopy should be considered the standard approach to minor liver resections. However, repeat liver resection is considered a challenging procedure owing to adhesions, anatomical distortion caused by the previous liver resection and other treatment modalities that are often used in the setting of recurrent disease.…”

Section: Introductionmentioning

confidence: 99%

Multicentre propensity score-matched study of laparoscopic versus open repeat liver resection for colorectal liver metastases

Poel

Barkhatov

Fuks

et al. 2019

British Journal of Surgery

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Background: Repeat liver resection is often the best treatment option for patients with recurrent colorectal liver metastases (CRLM). Repeat resections can be complex, however, owing to adhesions and altered liver anatomy. It remains uncertain whether the advantages of a laparoscopic approach are upheld in this setting. The aim of this retrospective, propensity score-matched study was to compare the short-term outcome of laparoscopic (LRLR) and open (ORLR) repeat liver resection.Methods: A multicentre retrospective propensity score-matched study was performed including all patients who underwent LRLRs and ORLRs for CRLM performed in nine high-volume centres from seven European countries between 2000 and 2016. Patients were matched based on propensity scores in a 1 : 1 ratio. Propensity scores were calculated based on 12 preoperative variables, including the approach to, and extent of, the previous liver resection. Operative outcomes were compared using paired tests. Results: Overall, 425 repeat liver resections were included. Of 271 LRLRs, 105 were matched with an ORLR. Baseline characteristics were comparable after matching. LRLR was associated with a shorter duration of operation (median 200 (i.q.r. 123-273) versus 256 (199-320) min; P < 0⋅001), less intraoperative blood loss (200 (50-450) versus 300 (100-600) ml; P = 0⋅077) and a shorter postoperative hospital stay (5 (3-8) versus 6 (5-8) days; P = 0⋅028). Postoperative morbidity and mortality rates were similar after LRLR and ORLR. Conclusion: LRLR for CRLM is feasible in selected patients and may offer advantages over an open approach.

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“…In addition, the R0 resection rate of LMH group was 96.2%. Recently, some meta-analyses of retrospective studies also observed that no significant difference was found between major LLR and major OLR in the resection margin for HCC patients [24,25]. In order to better learn major LLR for HCC patients, long-term survival rate should also be obtained.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic versus open major liver resection for hepatocellular carcinoma: a case-matched analysis of short- and long-term outcomes

Wang

et al. 2020

Preprint

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Background: The feasibility and safety of laparoscopic major hepatectomy (LMH) is still uncertain. The purpose of the present study is to compare the short- and long-term outcomes of LMH with those of open major hepatectomy (OMH) for hepatocellular carcinoma (HCC).Method: Between January 2012 and December 2018, a total of 26 patients received laparoscopic major hepatectomy in our center. To minimize any confounding factors, a 1:3 case-matched analysis was conducted based on the demographics and extent of liver resection. Data of demographics, perioperative outcomes and long-term oncologic outcomes were reviewed.Results: Intraoperative blood loss (P=0.007) were significantly lower in LMH group. In addition, LMH group exhibited a lower overall complication rate (P=0.039) and shorter postoperative hospital stay (P=0.024). However, no statistically significant difference was found between LMH and OMH regarding operation time (P=0.215) and overall cost (P=0.024). Two laparoscopic cases were converted to open liver resection. In regard with long-term outcomes, there was no significant difference between LMH and OMH regarding disease-free survival (DFS) (P=0.079) and overall survival (OS) (P=0.172).Conclusion: LMH can be an effective and safe alternative to OMH for selected patients with liver cancer in short- and long-term outcomes.

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Laparoscopic versus open major hepatectomy: a systematic review and meta-analysis of individual patient data

Cited by 160 publications

References 46 publications

Current topics in liver surgery

Current topics in liver surgery

Multicentre propensity score-matched study of laparoscopic versus open repeat liver resection for colorectal liver metastases

Laparoscopic versus open major liver resection for hepatocellular carcinoma: a case-matched analysis of short- and long-term outcomes

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