Laparoscopic Versus Open Hemihepatectomy: a 1:1 Matched Analysis

Overview

Journal Ann Transl Med

Publisher AME Publishing Company

Date 2020 May 13

PMID 32395475

Citations 3

Authors

Yifan Wang

Jing Fang

Liumei Lin

Long Pan

Junjie Nan

XinHua Cui

Hui Liu

Mingyu Chen

Qiuxia Gu

Xiujun Cai

Affiliations

Soon will be listed here.

Abstract

Background: Laparoscopic liver resection has increased rapidly and procedure has almost extended to all the types of liver resection. Major liver resections, such as hemihepatectomies, were still innovative procedures in the exploration phase and continued cautious introduction of major laparoscopic liver resections was recommended by experts. The study aims to evaluate the safety of laparoscopic hemihepatectomy (LH) by the comparing with open hemihepatectomy (OH).

Methods: Patients who underwent hemihepatectomy in Sir Run Run Shaw Hospital from January 2012 to December 2017 were reviewed. A 1:1 matched study was performed between LH group and OH group. Patients who fail to be matched were excluded. Perioperative outcomes, complications and cost were compared between LH group and OH group.

Results: One hundred and thirty-eight exact matches for all matching variables were found between LH patients and OH patients. The length of postoperative hospital stay of LH group was significant shorter than the OH group (P=0.031). Intraoperative blood loss (P=0.005) and transfusion rate (P=0.001) in the LH group were significantly lower than the OH group. There was no mortality in either group. Twenty-six patients in LH group and 31 patients in OH group had complications and all of them recovered uneventfully after immediate treatments. The hospital expense of LH group was significantly higher than OH group (P<0.001).

Conclusions: These results lead us to believe that LH is a safe procedure and it could be performed routinely in experienced laparoscopic centers.

Citing Articles

A Comparative Study of Laparoscopic and Open Approaches for Right Hemihepatectomy in Hepatocellular Carcinoma Patients: Safety and Short-Term Outcomes.

Li G, Mugaanyi J, Li Z, Bao Y, Lu C, Huang J Med Sci Monit. 2024; 30:e942096.

PMID: 38311848 PMC: 10854201. DOI: 10.12659/MSM.942096.

A systematic review and meta-analysis of blood transfusion rates during liver resection by country.

Kim S, Jung Y, Lee K, Kim K, Kim H, Choi D Ann Surg Treat Res. 2023; 105(6):404-416.

PMID: 38076606 PMC: 10703584. DOI: 10.4174/astr.2023.105.6.404.

Economic analysis of open versus laparoscopic versus robotic hepatectomy: a systematic review and meta-analysis.

Ziogas I, Evangeliou A, Mylonas K, Athanasiadis D, Cherouveim P, Geller D Eur J Health Econ. 2021; 22(4):585-604.

PMID: 33740153 DOI: 10.1007/s10198-021-01277-1.

References

Yoon Y, Kim K, Kang S, Kim W, Shin M, Lee S . Pure Laparoscopic Versus Open Right Hepatectomy for Hepatocellular Carcinoma in Patients With Cirrhosis: A Propensity Score Matched Analysis. Ann Surg. 2016; 265(5):856-863. DOI: 10.1097/SLA.0000000000002072. View

Okuno M, Goumard C, Mizuno T, Omichi K, Tzeng C, Chun Y . Operative and short-term oncologic outcomes of laparoscopic versus open liver resection for colorectal liver metastases located in the posterosuperior liver: a propensity score matching analysis. Surg Endosc. 2017; 32(4):1776-1786. PMC: 5845466. DOI: 10.1007/s00464-017-5861-x. View

Ikeda T, Toshima T, Harimoto N, Yamashita Y, Ikegami T, Yoshizumi T . Laparoscopic liver resection in the semiprone position for tumors in the anterosuperior and posterior segments, using a novel dual-handling technique and bipolar irrigation system. Surg Endosc. 2014; 28(8):2484-92. PMC: 4077249. DOI: 10.1007/s00464-014-3469-y. View

Jin R, Wang Y, Yu H, Liang X, Cai X . Total laparoscopic left hepatectomy for primary hepatolithiasis: Eight-year experience in a single center. Surgery. 2015; 159(3):834-41. DOI: 10.1016/j.surg.2015.09.022. View

Cleary S, Han H, Yamamoto M, Wakabayashi G, Asbun H . The comparative costs of laparoscopic and open liver resection: a report for the 2nd International Consensus Conference on Laparoscopic Liver Resection. Surg Endosc. 2016; 30(11):4691-4696. DOI: 10.1007/s00464-016-4801-5. View

Aikawa M, Miyazawa M, Okamoto K, Toshimitsu Y, Okada K, Ueno Y . Thoracoscopic hepatectomy for malignant liver tumor. Surg Endosc. 2013; 28(1):314. DOI: 10.1007/s00464-013-3128-8. View

Wakabayashi G, Cherqui D, Geller D, Buell J, Kaneko H, Han H . Recommendations for laparoscopic liver resection: a report from the second international consensus conference held in Morioka. Ann Surg. 2015; 261(4):619-29. DOI: 10.1097/SLA.0000000000001184. View

Cipriani F, Alzoubi M, Fuks D, Ratti F, Kawai T, Berardi G . Pure laparoscopic versus open hemihepatectomy: a critical assessment and realistic expectations - a propensity score-based analysis of right and left hemihepatectomies from nine European tertiary referral centers. J Hepatobiliary Pancreat Sci. 2019; 27(1):3-15. DOI: 10.1002/jhbp.662. View

Clavien P, Barkun J, De Oliveira M, Vauthey J, Dindo D, Schulick R . The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009; 250(2):187-96. DOI: 10.1097/SLA.0b013e3181b13ca2. View

10.

Morise Z . Laparoscopic liver resection for posterosuperior tumors using caudal approach and postural changes: A new technical approach. World J Gastroenterol. 2017; 22(47):10267-10274. PMC: 5175240. DOI: 10.3748/wjg.v22.i47.10267. View

11.

Reich H, McGlynn F, DeCaprio J, Budin R . Laparoscopic excision of benign liver lesions. Obstet Gynecol. 1991; 78(5 Pt 2):956-8. View

12.

Cai X, Wang Y, Yu H, Liang X, Peng S . Laparoscopic hepatectomy for hepatolithiasis: a feasibility and safety study in 29 patients. Surg Endosc. 2007; 21(7):1074-8. DOI: 10.1007/s00464-007-9306-9. View

13.

Ichida H, Ishizawa T, Tanaka M, Terasawa M, Watanabe G, Takeda Y . Use of intercostal trocars for laparoscopic resection of subphrenic hepatic tumors. Surg Endosc. 2016; 31(3):1280-1286. DOI: 10.1007/s00464-016-5107-3. View

14.

Lin N, Nitta H, Wakabayashi G . Laparoscopic major hepatectomy: a systematic literature review and comparison of 3 techniques. Ann Surg. 2012; 257(2):205-13. DOI: 10.1097/SLA.0b013e31827da7fe. View

15.

Coelho F, Pirola Kruger J, Fonseca G, Araujo R, Jeismann V, Perini M . Laparoscopic liver resection: Experience based guidelines. World J Gastrointest Surg. 2016; 8(1):5-26. PMC: 4724587. DOI: 10.4240/wjgs.v8.i1.5. View

16.

Nguyen K, Clark Gamblin T, Geller D . World review of laparoscopic liver resection-2,804 patients. Ann Surg. 2009; 250(5):831-41. DOI: 10.1097/SLA.0b013e3181b0c4df. View

17.

Abu Hilal M, Aldrighetti L, Dagher I, Edwin B, Troisi R, Alikhanov R . The Southampton Consensus Guidelines for Laparoscopic Liver Surgery: From Indication to Implementation. Ann Surg. 2017; 268(1):11-18. DOI: 10.1097/SLA.0000000000002524. View

18.

Buell J, Cherqui D, Geller D, ORourke N, Iannitti D, Dagher I . The international position on laparoscopic liver surgery: The Louisville Statement, 2008. Ann Surg. 2009; 250(5):825-30. DOI: 10.1097/sla.0b013e3181b3b2d8. View

19.

Ciria R, Cherqui D, Geller D, Briceno J, Wakabayashi G . Comparative Short-term Benefits of Laparoscopic Liver Resection: 9000 Cases and Climbing. Ann Surg. 2015; 263(4):761-77. DOI: 10.1097/SLA.0000000000001413. View

20.

Cai X, Wang Y, Liang Y, Yu H, Liang X . Laparoscopic left hemihepatectomy: a safety and feasibility study of 19 cases. Surg Endosc. 2009; 23(11):2556-62. DOI: 10.1007/s00464-009-0454-y. View