Annals of Surgical Oncology

, Volume 24, Issue 4, pp 1021–1028 | Cite as

Robotic Versus Open Hepatectomy for Hepatocellular Carcinoma: A Matched Comparison

  • Po-Da Chen
  • Chao-Ying Wu
  • Rey-Heng Hu
  • Wei-Han Chou
  • Hong-Shiee Lai
  • Jin-Tung Liang
  • Po-Huang Lee
  • Yao-Ming Wu
Hepatobiliary Tumors



Robotic hepatectomy has been suggested to be a safe and effective approach for liver disease; however, studies comparing robotic hepatectomy with the conventional open approach regarding oncologic outcomes for hepatocellular carcinoma (HCC) are limited. Accordingly, we performed a matched comparison of surgical and oncological outcomes between robotic and open hepatectomy.


Between January 2012 and October 2015, a total of 183 patients underwent robotic hepatectomy and 275 patients underwent open hepatectomy by the same surgical team in our center. Eighty-one newly diagnosed HCC cases in each group were compared under propensity score matching (PSM) in a 1:1 ratio.


With robotic hepatectomy, the conversion rate was 1.6 % and the complication rate was 4.4 %. On PSM, the groups had a comparable percentage of major liver resections (41.9 vs. 39.5 %) and liver cirrhosis (45.7 vs. 46.9 %). Compared with the open group, the robotic group required longer operation times (343 vs. 220 min), shorter hospital stays (7.5 vs. 10.1 days), and lower dosages of postoperative patient-controlled analgesia (350 vs. 554 ng/kg). The 3-year disease-free survival of the robotic group was comparable with that of the open group (72.2 % vs. 58.0 %; p = 0.062), as was the 3-year overall survival (92.6 vs. 93.7 %; p = 0.431).


This is the first oncological study comparing robotic liver resection for HCC with open resection. Robotic hepatectomy can be applied for challenging major resections in patients with cirrhotic liver disease with less postoperative pain and shorter hospital stays without compromising oncological outcomes.


Liver Resection Propensity Score Match Minimally Invasive Surgery Major Hepatectomy Robotic Group 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors would like to thank the Liver Disease Prevention and Treatment Research Foundation for their help throughout the course of this work. They also give special thanks to Miao Hsin for preparing the manuscript.

Conflicts of Interest


Supplementary material

10434_2016_5638_MOESM1_ESM.docx (19 kb)
Supplementary material 1 (DOCX 18 kb)


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Copyright information

© Society of Surgical Oncology 2016

Authors and Affiliations

  • Po-Da Chen
    • 1
  • Chao-Ying Wu
    • 1
  • Rey-Heng Hu
    • 1
  • Wei-Han Chou
    • 2
  • Hong-Shiee Lai
    • 1
  • Jin-Tung Liang
    • 1
  • Po-Huang Lee
    • 1
  • Yao-Ming Wu
    • 1
  1. 1.Department of SurgeryNational Taiwan University and National Taiwan University HospitalTaipeiTaiwan
  2. 2.Department of AnesthesiologyNational Taiwan University and National Taiwan University HospitalTaipeiTaiwan

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