Laparoscopic versus open liver resection: A matched-pair case control study

Kaori Ito, Hiromichi Ito, Chandrakanth Are, Peter J. Allen, Yuman Fong, Ronald P. DeMatteo, William R. Jarnagin, Michael I. D'Angelica

Research output: Contribution to journalArticlepeer-review

93 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)2276-2283
Number of pages8
JournalJournal of Gastrointestinal Surgery
Volume13
Issue number12
DOIs
StatePublished - Dec 2009

Keywords

  • Case control study
  • Laparoscopic liver resection
  • Minimal invasive surgery

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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