Laparoscopic versus open right hepatectomy: a comparative study.
BACKGROUND
The safety of laparoscopic major liver resections is still uncertain. The aim of this study was to compare our results for laparoscopic right hepatectomy (LRH) with those for open right hepatectomy (ORH).


METHODS
Patients undergoing LRH were compared with retrospectively selected patients from our ORH database. The 2 groups were well matched for sex, age, American Society of Anesthesiologists score, body mass index, liver disease, and tumor size. Surgical and postsurgical outcomes were compared.


RESULTS
Seventy-two patients were analyzed: 22 in the LRH group and 50 in the ORH group. Operating time was similar. Blood loss was significantly less in laparoscopic resections (P = .038). Specific morbidity rates were not different, general morbidity was lower after laparoscopy (P = .04), and the severity of postsurgical complications was not different. Mean hospital stay was significantly shorter after laparoscopy (P = .009).


CONCLUSIONS
Laparoscopy improved surgical and postsurgical outcomes for ORH in selected patients. This is the first comparative study to demonstrate an advantage of laparoscopy for a major liver resection. Prospective randomized studies with a greater number of cases are needed to confirm the role of laparoscopy in major liver resections.
Dagher
Ibrahim
I
Department of General Surgery, Antoine Béclère Hospital, Clamart, France. ibrahim.dagher@abc.aphp.fr
Di Giuro
Giuseppe
G
Dubrez
Julien
J
Lainas
Panagiotis
P
Smadja
Claude
C
Franco
Dominique
D
D016063:Blood Loss, Surgical; D001803:Blood Transfusion / Q000706:statistics & numerical data; D015331:Cohort Studies; D003250:Constriction; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods / Q000706:statistics & numerical data; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011168:Portal System; D012189:Retrospective Studies; D013997:Time Factors