Laparoscopic vs open hepatic resection: a comparative study.
BACKGROUND
Although the feasibility of minor laparoscopic liver resections (LLR) has been demonstrated, data comparing the open vs the laparoscopic approach to liver resection are lacking.


METHODS
We compared 30 LLR with 30 open liver resections (OLR) in a pair-matched analysis. The indications for resection were malignant disease in 47% of the LLR and 83% of the OLR. The average size of the lesions was 42 mm for LLR and 41 mm for OLR. Five wedge resections, 12 segmentectomies, and 13 bisegmentectomies were performed in each group.


RESULTS
The conversion rate for LLR was nil. The mean operative time was 148 min for LLR and 142 min for OLR. Mean blood loss was minimal in the LLR group (320 vs 479 ml; p < 0.05). Postoperative complications occurred in 6.6% of the patients in each group; there were no deaths. The mean postoperative hospital stay was shorter for LLR patients (6.4 vs 8.7 days; p < 0.05). In tumors, the resection margin was <1 cm in 43% of the LLR patients and 40% of the OLR patients ( p = NS).


CONCLUSIONS
Minor LLR of the anterior segments has the same rates of mortality and morbidity as OLR. However, the laparoscopic approach reduces blood loss and postoperative hospital stay.
Second Department of General Surgery, University of Turin, C.so A.M. Dogliotti 14, 10126 Turin, Italy. mario.morino@unito.it
M
M
Morino
I
I
Morra
E
E
Rosso
C
C
Miglietta
C
C
Garrone
D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D006528:Carcinoma, Hepatocellular / Q000601:surgery; D017081:Cholecystectomy, Laparoscopic; D003082:Colectomy; D005240:Feasibility Studies; D005260:Female; D006391:Hemangioma / Q000601:surgery; D006498:Hepatectomy / Q000379:methods* / Q000706:statistics & numerical data; D059685:Herniorrhaphy; D006801:Humans; D010535:Laparoscopy / Q000379:methods* / Q000706:statistics & numerical data; D007902:Length of Stay; D008113:Liver Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies