Abstract
Background
Laparoscopic liver resection (LLR) has become an increasingly popular operation; however, its theoretical benefits remain unproven. The aim of this study was to conduct a comparative outcome study between LLR and matched-pair open liver resections (OLR).
Methods
Sixty five patients underwent attempted LLR from 1998 through 2008; 52 of which were completed laparoscopically. Patients who underwent OLR prior to 1998 were matched to laparoscopic cases for demographics, comorbidities, diagnosis, tumor characteristics, procedure, and background liver. Perioperative and oncologic outcomes were compared between the two groups. Analyses were performed excluding and including conversion cases.
Results
Characteristics were comparable between both groups. LLR was associated with significant reductions in estimated blood loss, frequency of transfusion, frequency of Pringle maneuver, postoperative morbidity, time to recovery, length of hospital stay, and incidence of incisional hernia. For patients with malignant tumors, there were no positive surgical margins or local recurrence in either group and the overall pattern of recurrence was similar.
Conclusion
For well-selected patients, LLR is a feasible operation that does not compromise operative or oncologic outcomes. While LLR was associated with some benefits, these can only be definitively proven in a randomized controlled trial.
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Abbreviations
- LLR:
-
Laparoscopic liver resection
- OLR:
-
Open liver resection
- EBL:
-
Estimated blood loss
- CVP:
-
Central venous pressure
- HALLR:
-
Hand-assisted laparoscopic liver resection
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Author contributions
Conception and design: K. Ito, D’Angelica
Acquisition of data: K. Ito, Are
Analysis and interpretation of data: K. Ito, H. Ito, D’Angelica
Drafting of the manuscript: K. Ito, Are, D’Angelica
Critical revision of the manuscript: D’Angelica, H. Ito, Allen, Fong, DeMatteo, Jarnagin
Statistical expertise: K. Ito, H. Ito
Supervision: D’Angelica
This study was presented at the 24th Annual SSAT Research Conference on May 30th, 2009, Chicago, IL and at the 50th Annual SSAT Meeting on June 2, 2009, Chicago, IL.
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Ito, K., Ito, H., Are, C. et al. Laparoscopic versus Open Liver Resection: A Matched-Pair Case Control Study. J Gastrointest Surg 13, 2276–2283 (2009). https://doi.org/10.1007/s11605-009-0993-5
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DOI: https://doi.org/10.1007/s11605-009-0993-5