Skip to main content

Advertisement

SpringerLink
Log in

Short-Term Outcomes of Totally Laparoscopic Central Hepatectomy and Right Anterior Sectionectomy for Centrally Located Tumors: A Case-Matched Study with Propensity Score Matching

  • Original Scientific Report
  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

Recent advances in technology and accumulation of surgical experience have expanded the indications for laparoscopic liver resection (LLR). However, compared to open liver resection (OLR), the feasibility of laparoscopic anatomical liver resection for centrally located tumor (CLT) has not been clearly established. The aim of our study was to assess the feasibility and safety of laparoscopic anatomical major liver resection for CLT.

Methods

From April 2011 to March 2016, 20 cases of anatomical LLR and 86 cases of OLR for CLTs such as central hepatectomy (CH) and right anterior sectionectomy (RAS) were performed at a single institution. We performed one-to-one propensity score matching and analyzed short-term outcomes between the LLR (n = 20) and OLR (n = 20) groups.

Results

Among 20 cases in the LLR group, two cases underwent open conversion due to common bile duct injury and anatomical distortion, respectively. There were no statistically significant difference between the LLR and OLR groups regarding clamping time of the Pringle maneuver (p = 0.502), blood loss (p = 0.746), surgical margin (p = 0.198), or length of hospital stay (p = 0.110). However, surgical time was significantly longer in the LLR group than in the OLR group (388 vs 268 min; p < 0.001). There were no significant differences between the two groups with regard to morbidity rate or mean comprehensive complication index (p = 0.716 and p = 0.819, respectively).

Conclusion

Total anatomical LLR can be performed safely in selected CLT patients by experienced surgeons. Laparoscopic CH or RAS appears feasible with non-inferior perioperative outcomes compared to OLR.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Gagner M, Rheault M, Dubuc J (1992) Laparoscopic partial hepatectomy for liver tumor. Surg Endosc 6:97–98

    Google Scholar 

  2. Buell JF, Cherqui D, Geller DA et al (2009) The international position on laparoscopic liver surgery: the Louisville Statement, 2008. Ann Surg 250:825–830

    Article  PubMed  Google Scholar 

  3. Wakabayashi G, Cherqui D, Geller DA et al (2015) Recommendations for laparoscopic liver resection: a report from the second international consensus conference held in Morioka. Ann Surg 261:619–629

    PubMed  Google Scholar 

  4. Lee GC, Kwon CHD, Joh JW et al (2011) Preliminary experience of laparoscopic hepatectomy for hepatocellular carcinoma. Korean J Hepatobiliary Pancreat Surg 15:7–12

    Google Scholar 

  5. Parks KR, Kuo YH, Davis JM et al (2014) Laparoscopic versus open liver resection: a meta-analysis of long-term outcome. HPB (Oxford) 16:109–118

    Article  Google Scholar 

  6. Ho CM, Wakabayashi G, Nitta H et al (2013) Total laparoscopic limited anatomical resection for centrally located hepatocellular carcinoma in cirrhotic liver. Surg Endosc 27:1820–1825

    Article  PubMed  Google Scholar 

  7. Machado MA, Kalil AN (2011) Glissonian approach for laparoscopic mesohepatectomy. Surg Endosc 25:2020–2022

    Article  CAS  PubMed  Google Scholar 

  8. Kim YK, Han HS, Yoon YS et al (2015) Total anatomical laparoscopic liver resection of segment 4 (s4), extended s4, and subsegments s4a and s4b for hepatocellular carcinoma. J Laparoendosc Adv Surg Tech A 25:375–379

    Article  PubMed  Google Scholar 

  9. Yoon YS, Han HS, Cho JY et al (2009) Totally laparoscopic central bisectionectomy for hepatocellular carcinoma. J Laparoendosc Adv Surg Tech A 19:653–656

    Article  PubMed  Google Scholar 

  10. Wolters U, Wolf T, Stutzer H et al (1996) ASA classification and perioperative variables as predictors of postoperative outcome. Br J Anaesth 77:217–222

    Article  CAS  PubMed  Google Scholar 

  11. Takasaki K (1998) Glissonean pedicle transection method for hepatic resection: a new concept of liver segmentation. J Hepatobiliary Pancreat Surg 5:286–291

    Article  CAS  PubMed  Google Scholar 

  12. Lee N, Cho CW, Kim JM et al (2017) Application of temporary inflow control of the Glissonean pedicle method provides a safe and easy technique for totally laparoscopic hemihepatectomy by Glissonean approach. Ann Surg Treat Res 92:383–386. doi:10.4174/astr.2017.92.5.383

    Article  PubMed  PubMed Central  Google Scholar 

  13. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213

    Article  PubMed  PubMed Central  Google Scholar 

  14. Han HS, Shehta A, Ahn S et al (2015) Laparoscopic versus open liver resection for hepatocellular carcinoma: case-matched study with propensity score matching. J Hepatol 63:643–650

    Article  PubMed  Google Scholar 

  15. Koch M, Garden OJ, Padbury R et al (2011) Bile leakage after hepatobiliary and pancreatic surgery: a definition and grading of severity by the international study group of liver surgery. Surgery 149:680–688

    Article  PubMed  Google Scholar 

  16. Ban D, Kudo A, Ito H et al (2015) The difficulty of laparoscopic liver resection. Updates Surg 67:123–128

    Article  PubMed  Google Scholar 

  17. Sartori S, Tombesi P, Macario F et al (2008) Subcapsular liver tumors treated with percutaneous radiofrequency ablation: a prospective comparison with nonsubcapsular liver tumors for safety and effectiveness. Radiology 248:670–679

    Article  PubMed  Google Scholar 

  18. Yoon YS, Han HS, Cho JY et al (2013) Laparoscopic liver resection for centrally located tumors close to the hilum, major hepatic veins, or inferior vena cava. Surgery 153:502–509

    Article  PubMed  Google Scholar 

  19. Lesurtel M, Cherqui D, Laurent A et al (2003) Laparoscopic versus open left lateral hepatic lobectomy: a case-control study. J Am Coll Surg 196:236–242

    Article  PubMed  Google Scholar 

  20. Chang S, Laurent A, Tayar C et al (2007) Laparoscopy as a routine approach for left lateral sectionectomy. Br J Surg 94:58–63

    Article  CAS  PubMed  Google Scholar 

  21. Ahn KS, Kang KJ, Kim YH et al (2014) A propensity score-matched case-control comparative study of laparoscopic and open liver resection for hepatocellular carcinoma. J Laparoendosc Adv Surg Tech A 24:872–877

    Article  PubMed  Google Scholar 

  22. Ciria R, Cherqui D, Geller DA et al (2016) Comparative short-term benefits of laparoscopic liver resection: 9000 cases and climbing. Ann Surg 263:761–777

    Article  PubMed  Google Scholar 

  23. Ban D, Tanabe M, Ito H et al (2014) A novel difficulty scoring system for laparoscopic liver resection. J Hepatobiliary Pancreat Sci 21:745–753

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea

    Chan Woo Cho, Jinsoo Rhu, Choon Hyuck David. Kwon, Gyu-Seong Choi, Jong Man Kim & Jae-Won Joh

  2. Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Kwang-Cheol Koh

  3. Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Gaab Soo Kim

Authors
  1. Chan Woo Cho
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jinsoo Rhu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Choon Hyuck David. Kwon
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gyu-Seong Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jong Man Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jae-Won Joh
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kwang-Cheol Koh
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Gaab Soo Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Choon Hyuck David. Kwon.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cho, C.W., Rhu, J., Kwon, C.H.D. et al. Short-Term Outcomes of Totally Laparoscopic Central Hepatectomy and Right Anterior Sectionectomy for Centrally Located Tumors: A Case-Matched Study with Propensity Score Matching. World J Surg 41, 2838–2846 (2017). https://doi.org/10.1007/s00268-017-4105-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-017-4105-5

Search

Navigation