LAPAROSCOPIC VERSUS OPEN LIVER RESECTION FOR TREATMENT OF LIVER TUMORS: EARLY EXPERIENCE OUTCOMES

Abstract

Although minimally invasive liver surgery has been increasingly practiced worldwide, the lack of experience is a barrier for numerous surgeons to initiate. This study aims to compare the outcome of laparoscopic liver resection (LLR) versus open liver resection (OLR) by surgeons who begin to conduct both procedures through the same period. We retrospectively analyzed the demographic data, the perioperative data, and the surgical outcomes of patients who underwent liver resection for the treatment of liver tumors. All procedures were operated by three hepato-pancreato-biliary (HPB) surgeons. In total 56 hepatectomies were operated on, 13 patients in the LLR group with an average Iwate score of 5, and 43 patients in the OLR group were included in the study. After propensity score matching, comparing 13 patients of each LLR and OLR groups, the operative time (316.5 vs 315.4 minutes, P = 0.98) and the amount of blood loss (929 vs 1500 mL, P = 0.23) were not different. The postoperative length of stay was significantly shorter in the LR group (6 vs 12 days, P = 0.009). The LLR group had a lower severity of the complications (P = 0.02), and the mortality rate was zero in both groups. The margin-free status did not differ between the LLR and OLR groups (92.3% vs 76.9%, P = 0.28). For HPB surgeons with limited experience, LLR is safe to meticulously proceed for liver lesions. The advantage of LLR is fewer complications, and most importantly the margin-free status is comparable between both groups.