Laparoscopic partial liver resection improves the short-term outcomes compared to open surgery for liver tumors in the posterosuperior segments
The aim of this study was to compare the clinical outcomes between laparoscopic partial liver resection and open partial hepatectomy for tumors in the posterosuperior segments.
The clinical outcomes of patients who underwent either laparoscopic (n = 20) or open (n = 44) resection in segments 7/8 of the liver were initially evaluated. Because of disparities in the background characteristics, a case-matched study (1:1) was conducted. In addition, a comparative study of the patients who met the institutional criteria for laparoscopic partial hepatectomy was performed.
In the case-matched study, the laparoscopic technique required a longer operation time (p = 0.001), but was associated with less intraoperative blood loss (p = 0.021), a lower incidence of major complications (p = 0.014), higher levels of serum albumin on postoperative days 3 and 7 (p = 0.031 and p = 0.035), and earlier discharge (p = 0.001) than open resection. The results of the latter study were similar to those of the case-matched analysis.
Laparoscopic partial hepatectomy was a feasible procedure for treating tumors in the posterosuperior segments without compromising oncological safety and yielded better short-term outcomes than open techniques. In addition, this study provides concrete selection criteria for laparoscopic partial hepatectomy for difficult lesions.
KeywordsLaparoscopic liver resection Laparoscopic partial liver resection Laparoscopic partial hepatectomy Parenchyma-preserving liver resection Posterosuperior segments
Compliance with ethical standards
Conflict of interest
Takanori Morikawa and the co-authors have no conflicts of interest or financial ties to disclose in association with this study.
- 1.Wakabayashi G, Cherqui D, Geller DA, Buell JF, Kaneko H, Han HS, et al. Recommendations for laparoscopic liver resection: A report from the second international consensus conference held in Morioka. Ann Surg. 2015; 261:619–29.Google Scholar
- 10.Okuno M, Goumard C, Mizuno T, Omichi K, Tzeng CWD, Chun YS, et al. 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. 2018;32:1776–86.CrossRefPubMedGoogle Scholar
- 11.Scuderi V, Barkhatov L, Montalti R, Ratti F, Cipriani F, Pardo F, et al. Outcome after laparoscopic and open resections of posterosuperior segments of the liver. Br J Surg. 2016;22:2344–9.Google Scholar
- 13.Montalti R, Berardi G, Laurent S, Sebastiani S, Ferdinande L, Libbrecht LJ, et al. Laparoscopic liver resection compared to open approach in patients with colorectal liver metastasis improves further resectability: Oncological outcomes of a case-control matched-pairs analysis. Eur J Surg Oncol. 2014;40:536–44.CrossRefPubMedGoogle Scholar