A Match-Pair Analysis of Open Versus Laparoscopic Liver Surgery

BACKGROUND AND OBJECTIVES: In addition to general advantages of laparoscopic over open surgery, such as better cosmesis and faster recovery, laparoscopic liver surgery offers specific advantages. Improved liver function and potentially earlier postoperative oncologic treatment are suggested by the literature as benefits of laparoscopic over open liver surgery. The purpose of this analysis was to analyze the outcomes of laparoscopic liver surgery in our department. METHODS: All laparoscopic liver resections (LLRs) performed from January 2011 through July 2016 were identified from the institutional database and matched 1:2 to open liver resections (OLRs). Data were analyzed regarding perioperative outcome, and significance was set at P < .05. RESULTS: Of 1525 liver resections, 120 patients were included in this analysis. Forty resections were performed laparoscopically. Patients in the LLR group more often had benign tumors. No patient died after LLR, but 2 required conversion to open surgery (5%) because of bleeding. Blood loss (200 vs 500 mL, P < .001) was less and hospital stay (6 vs. 7 days, P = .001) shorter after LLR. Iwate score, operating time, and the size of the resection margins did not differ between the groups. Iwate score correlated with operative time (P = .027). CONCLUSIONS: Laparoscopic liver surgery was safe, and several advantages over open surgery were confirmed in our series.