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Single-centre comparative study of laparoscopic versus open right hepatectomy

Single-centre comparative study of laparoscopic versus open right hepatectomy
Single-centre comparative study of laparoscopic versus open right hepatectomy
Background

Expansion of laparoscopic major hepatectomy is still limited mainly due to the well-recognised technical difficulties compared to open surgery, and doubts regarding the oncological efficiency when major resections are required.

Methods

Patients undergoing open right hepatectomy (ORH) were matched with patients undergoing laparoscopic right hepatectomy (LRH) and compared for perioperative outcomes.

Results

Seventy patients were included: 36 patients underwent LRH and 34 ORH. Operative time was significantly longer for LRH (median, 300 min vs. 180 min for ORH; p?<?0.0001). Intensive care unit (median, 2 days for LRH vs. 4 days for ORH; p?<?0.0001) and postoperative length of stay (5 days for LRH vs. 9 days for ORH; p?<?0.0001) were significantly shorter for LRH. Four laparoscopic cases were converted to open surgery. No significant difference in postoperative complications and mortality was observed between LRH and ORH. Among patients with colorectal carcinoma liver metastases, R0 resection was obtained in 20/21 (95%) cases after LRH, and in 20/25 (80%) after ORH (p?=?0.198). Mid-term overall survival did not significantly differ between the laparoscopic and the open group.

Conclusions

LRH can be a safe, effective, and oncologically efficient alternative to open resection in selected cases. Extensive experience in hepatic and laparoscopic surgery is required.
right hepatectomy, laparoscopy, case–control study, outcome survival
1091-255X
818-23
Abu Hilal, Mohammed
384e1c60-8519-4eed-8e92-91775aad4c47
Di Fabio, Francesco
5318ae30-aac4-49ab-b11c-289ae2049cdf
Teng, Mabel Joey
4b5ab744-ed5c-4174-b2c8-1fc0b779d44a
Lykoudis, Pavlos
bc705761-0eca-4ad3-bc38-359f13760d41
Primrose, John Neil
d85f3b28-24c6-475f-955b-ec457a3f9185
Pearce, Neil William
12ab5ca5-a80c-4fe9-ab31-725048d6c747
Abu Hilal, Mohammed
384e1c60-8519-4eed-8e92-91775aad4c47
Di Fabio, Francesco
5318ae30-aac4-49ab-b11c-289ae2049cdf
Teng, Mabel Joey
4b5ab744-ed5c-4174-b2c8-1fc0b779d44a
Lykoudis, Pavlos
bc705761-0eca-4ad3-bc38-359f13760d41
Primrose, John Neil
d85f3b28-24c6-475f-955b-ec457a3f9185
Pearce, Neil William
12ab5ca5-a80c-4fe9-ab31-725048d6c747

Abu Hilal, Mohammed, Di Fabio, Francesco, Teng, Mabel Joey, Lykoudis, Pavlos, Primrose, John Neil and Pearce, Neil William (2011) Single-centre comparative study of laparoscopic versus open right hepatectomy. Journal of Gastrointestinal Surgery, 15 (5), 818-23. (doi:10.1007/s11605-011-1468-z). (PMID:21380633)

Record type: Article

Abstract

Background

Expansion of laparoscopic major hepatectomy is still limited mainly due to the well-recognised technical difficulties compared to open surgery, and doubts regarding the oncological efficiency when major resections are required.

Methods

Patients undergoing open right hepatectomy (ORH) were matched with patients undergoing laparoscopic right hepatectomy (LRH) and compared for perioperative outcomes.

Results

Seventy patients were included: 36 patients underwent LRH and 34 ORH. Operative time was significantly longer for LRH (median, 300 min vs. 180 min for ORH; p?<?0.0001). Intensive care unit (median, 2 days for LRH vs. 4 days for ORH; p?<?0.0001) and postoperative length of stay (5 days for LRH vs. 9 days for ORH; p?<?0.0001) were significantly shorter for LRH. Four laparoscopic cases were converted to open surgery. No significant difference in postoperative complications and mortality was observed between LRH and ORH. Among patients with colorectal carcinoma liver metastases, R0 resection was obtained in 20/21 (95%) cases after LRH, and in 20/25 (80%) after ORH (p?=?0.198). Mid-term overall survival did not significantly differ between the laparoscopic and the open group.

Conclusions

LRH can be a safe, effective, and oncologically efficient alternative to open resection in selected cases. Extensive experience in hepatic and laparoscopic surgery is required.

Full text not available from this repository.

More information

e-pub ahead of print date: 5 March 2011
Published date: May 2011
Keywords: right hepatectomy, laparoscopy, case–control study, outcome survival
Organisations: Cancer Sciences

Identifiers

Local EPrints ID: 350710
URI: https://eprints.soton.ac.uk/id/eprint/350710
ISSN: 1091-255X
PURE UUID: 063771ad-21fd-4cc8-9d25-590286f17c4d
ORCID for John Neil Primrose: ORCID iD orcid.org/0000-0002-2069-7605

Catalogue record

Date deposited: 09 Apr 2014 15:42
Last modified: 29 Oct 2019 02:06

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Contributors

Author: Mohammed Abu Hilal
Author: Francesco Di Fabio
Author: Mabel Joey Teng
Author: Pavlos Lykoudis
Author: Neil William Pearce

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