Laparoscopic vs. open liver resections of posterolateral liver segments – a systematic review and meta-analysis

Laparoscopic liver resection has become a standard practice in many surgical wards in elective liver surgery, due to its positive impact on reducing hospital stay and postoperative complications, including lower blood loss and transfusion rate. However, achieving proper hemostasis in liver surgery, due to its vast blood supply, still remains a main concern to surgeons. Therefore, numerous techniques were and are still being developed to further reduce blood loss and transfusion rate. The aim of this literature review was to summarize the best available methods for achieving the minimal blood loss and transfusion rate in laparoscopic liver surgery, according to the newest data.

Section: Discussionmentioning

confidence: 99%

Minimizing blood loss and transfusion rate in laparoscopic liver surgery: a review

Serednicki¹,

Hołówko²,

Major³

et al. 2023

“…In addition, the heterogeneity between studies is high, making it difficult to generalize their clinical value. In addition, longer surgical times may have little impact on clinical outcomes [25].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic versus conventional open treatment of hepatic cystic hydatidosis: a systematic review and meta-analysis of cohort studies

Wang¹,

Zhu²,

Yang³

et al. 2022

Introduction: There still exist controversies about the advantages and disadvantages of laparoscopic and traditional open surgery. Aim: This meta-analysis aimed to compare the efficacy and safety of laparoscopic versus traditional laparotomy in hepatic cystic hydatidosis. Material and methods: A systematic literature search was conducted for studies about liver hydatid surgery. After the quality assessment and relevant data extraction, the article was screened and included according to the inclusion and exclusion criteria. Meta-analysis was performed using RevMan 5.3 software. Results: Thirteen studies included 1211 cases, 362 in the laparoscopic group, and 849 in the open surgery group. According to meta-analysis, laparoscopic surgery is superior to traditional open surgery in terms of length of hospital stay, the recovery time of gastrointestinal function, total complications, and the risk of incision infection. There were no significant differences between laparoscopic surgery and traditional open surgery in operation time, postoperative time of abdominal drainage tube removal, recurrence rate, bile leakage rate, biliary fistula rate, and residual cavity infection rate.Conclusions: Laparoscopy is superior to traditional open surgery in terms of length of hospital stay, the recovery time of gastrointestinal function, total complications, and the risk of incision infection. There was no significant difference in postoperative recurrence between laparoscopy and open surgery. In addition, we think laparoscopy can achieve the same clinical effect as laparotomy. However, the reliability and validity of our conclusion need to be verified by more randomized controlled trials (RCTs).

“…At present, surgery is one of the best choices to treat LD [ 26 ]. However, due to the complex anatomical structure and many anatomical variations of the liver vasculature, it is difficult to obtain visual information and diagrams of the fine liver anatomy [ 27 ], especially in laparoscopic special segmental hepatectomy [ 28 ]. Therefore, obtaining accurate anatomical images of the liver prior to surgery for the accurate resection of liver lesions has become a hot topic of current research.…”

Section: Discussionmentioning

confidence: 99%

Three-dimensional versus two-dimensional video-assisted hepatectomy for liver disease: a meta-analysis of clinical data

Zhang¹,

Huang²,

Cai³

et al. 2021

Introduction: The benefit of three-dimensional (3D) visualization for liver disease is uncertain. Aim: To evaluate the effectiveness and safety of 3D versus two-dimensional (2D) video-assisted hepatectomy for LD. Material and methods: We searched PubMed, Embase, Cochrane Library, Medline, and Web of Science for studies addressing 3D versus 2D for 2D until 30 February 2020. Study-specific effect sizes and their 95% confidence intervals (CIs) were combined to calculate the pooled value using a fixed-effects or random-effects model. Results: Nine studies with 808 patients were included. The 3D group had shorter operative time (mean difference (