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Comparative Study
. 2019 Mar;49(3):214-223.
doi: 10.1007/s00595-018-1719-7. Epub 2018 Sep 24.

Laparoscopic Partial Liver Resection Improves the Short-Term Outcomes Compared to Open Surgery for Liver Tumors in the Posterosuperior Segments

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Comparative Study

Laparoscopic Partial Liver Resection Improves the Short-Term Outcomes Compared to Open Surgery for Liver Tumors in the Posterosuperior Segments

Takanori Morikawa et al. Surg Today. .

Abstract

Purpose: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Laparoscopic liver resection; Laparoscopic partial hepatectomy; Laparoscopic partial liver resection; Parenchyma-preserving liver resection; Posterosuperior segments.

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