Laparoscopic Versus Open Hemihepatectomy: A 1:1 Matched Analysis

Ann Transl Med. 2020 Apr;8(7):431. doi: 10.21037/atm.2020.03.188.


Background: Laparoscopic liver resection has increased rapidly and procedure has almost extended to all the types of liver resection. Major liver resections, such as hemihepatectomies, were still innovative procedures in the exploration phase and continued cautious introduction of major laparoscopic liver resections was recommended by experts. The study aims to evaluate the safety of laparoscopic hemihepatectomy (LH) by the comparing with open hemihepatectomy (OH).

Methods: Patients who underwent hemihepatectomy in Sir Run Run Shaw Hospital from January 2012 to December 2017 were reviewed. A 1:1 matched study was performed between LH group and OH group. Patients who fail to be matched were excluded. Perioperative outcomes, complications and cost were compared between LH group and OH group.

Results: One hundred and thirty-eight exact matches for all matching variables were found between LH patients and OH patients. The length of postoperative hospital stay of LH group was significant shorter than the OH group (P=0.031). Intraoperative blood loss (P=0.005) and transfusion rate (P=0.001) in the LH group were significantly lower than the OH group. There was no mortality in either group. Twenty-six patients in LH group and 31 patients in OH group had complications and all of them recovered uneventfully after immediate treatments. The hospital expense of LH group was significantly higher than OH group (P<0.001).

Conclusions: These results lead us to believe that LH is a safe procedure and it could be performed routinely in experienced laparoscopic centers.

Keywords: Laparoscopic liver resection; cost; hemihepatectomy.