Surgical Endoscopy

, Volume 33, Issue 4, pp 1131–1139 | Cite as

Long-term and short-term surgical outcomes of laparoscopic versus open liver resection for hepatocellular carcinoma: might laparoscopic approach be better in early HCC?

  • Kuei-Yen Tsai
  • Hsin-An Chen
  • Wan-Yu Wang
  • Ming-Te HuangEmail author



This retrospective study compared the short- and long-term outcomes of laparoscopic liver resection (LLR) and open liver resection (OLR) and identified patients who might gain more benefits from LLR.


The demographic and perioperative data, short-term surgical outcomes, and long-term oncological results of all 313 patients who received elective liver resection for hepatocellular carcinoma (HCC) between January 2010 and June 2017 were analyzed. The patients were then divided into stage-specific subgroups according to the TNM staging system for comparison.


LLR was performed in 153 patients and OLR in 160 patients. LLR is associated with less blood loss (p < 0.001), shorter surgical time (p = 0.001), shorter length of hospital stay (p < 0.001), and lower morbidity rate (p = 0.034). The 5-year overall survival (OS) rates in the LLR group were higher than those in the OLR group (78.1 vs. 57.6%; p = 0.002). Stage-specific subgroup analysis revealed similar 5-year OS in the two groups (stage I: 82.8 vs. 82.6%, p = 0.845; stage II: 80.3 vs. 69.2%, p = 0.638; stage III: 55.6 vs. 34.8%, p = 0.681), as did the 5-year recurrence-free survival. Moreover, the short-term outcomes were better in the LLR group in terms of surgical time, blood loss, and length of hospital stay, and these benefits attenuated with advancing tumor stage.


LLR for HCC is a safe and feasible procedure that does not compromise long-term oncological outcomes. In early tumor stages, LLR might be better in terms of short-term surgical outcomes.


Laparoscopic hepatectomy Overall survival Recurrence-free survival Stage-specific prognosis 



This manuscript was edited by Wallace Academic Editing.

Compliance with ethical standards


Drs. Kuei-Yen Tsai, Hsin-An Chen, Wan-Yu Wang, and Ming-Te Huang have no conflict of interest or financial ties to disclose.


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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of General Surgery, Department of SurgeryTaipei Medical University Shuang Ho HospitalNew Taipei CityTaiwan, Republic of China
  2. 2.Division of General Surgery, Department of Surgery, School of Medicine, College of MedicineTaipei Medical UniversityTaipei CityTaiwan, Republic of China

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