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Journal of Gastrointestinal Surgery

, Volume 20, Issue 9, pp 1608–1617 | Cite as

Minimally Invasive vs. Open Hepatectomy: a Comparative Analysis of the National Surgical Quality Improvement Program Database

  • Fabio Bagante
  • Gaya Spolverato
  • Steven M. Strasberg
  • Faiz Gani
  • Vanessa Thompson
  • Bruce L. Hall
  • David J. Bentrem
  • Henry A. Pitt
  • Timothy M. Pawlik
2016 SSAT Poster Presentation

Abstract

Background

While minimally invasive surgery (MIS) to treat liver tumors has increased, data on perioperative outcomes of MIS relative to open liver resection (O-LR) are lacking. We sought to compare short-term outcomes among patients undergoing MIS vs. O-LR in a nationally representative database.

Methods

The National Surgical Quality Improvement Program database was used to identify patients undergoing hepatectomy between January 1 and December 31, 2014. Propensity score matching algorithm was used to balance differences in baseline characteristics among MIS and O-LR groups.

Results

A total of 3064 patients were included in the study. After propensity matching, the baseline characteristics for O-LR and MIS groups were comparable (minimum p value = 0.12). Incidence of superficial surgical site infections, intraoperative or postoperative blood transfusions, and pulmonary embolism was lower among patients in MIS group compared to O-LR (p < 0.02). Liver failure and biliary leakage were also less frequent among patients undergoing MIS (p < 0.01). Similarly, MIS was associated with a shorter length of hospital stay (LOS) compared to O-LR (p < 0.001). Of note, 30-day postoperative mortality and readmission were comparable between the two groups.

Conclusions

Patients undergoing MIS had a lower postoperative morbidity and shorter LOS compared with patients undergoing O-LR. MIS is safe and may be associated with improved short-term outcomes following hepatic surgery.

Keywords

Liver surgery Minimally invasive surgery Laparoscopic surgery Robotic surgery 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no competing interests.

Authors’ Contributions

All authors designed the work, revised the manuscript critically for important intellectual content, approved the final version to be published, and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Fabio Bagante, Gaya Spolverato, and Timothy M. Pawlik analyzed and interpreted data. Fabio Bagante, Gaya Spolverato, and Timothy M. Pawlik drafted the work.

Supplementary material

11605_2016_3202_MOESM1_ESM.doc (54 kb)
ESM 1 (DOC 53 kb)

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Copyright information

© The Society for Surgery of the Alimentary Tract 2016

Authors and Affiliations

  • Fabio Bagante
    • 1
  • Gaya Spolverato
    • 1
  • Steven M. Strasberg
    • 2
  • Faiz Gani
    • 1
  • Vanessa Thompson
    • 3
  • Bruce L. Hall
    • 2
  • David J. Bentrem
    • 4
  • Henry A. Pitt
    • 5
  • Timothy M. Pawlik
    • 1
  1. 1.Department of SurgeryJohns Hopkins University School of MedicineBaltimoreUSA
  2. 2.Department of SurgeryWashington University in St. LouisSt. LouisUSA
  3. 3.American College of Surgeons - National Surgical Quality Improvement ProgramChicagoUSA
  4. 4.Department of SurgeryNorthwestern University Feinberg School of MedicineChicagoUSA
  5. 5.Department of SurgeryLewis Katz School of Medicine at Temple UniversityPhiladelphiaUSA

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