Surgical Endoscopy

, Volume 32, Issue 3, pp 1478–1485 | Cite as

Laparoscopic versus open parenchymal preserving liver resections in the posterosuperior segments: a case-matched study

  • Mathieu D’Hondt
  • Esther Tamby
  • Isabelle Boscart
  • Simon Turcotte
  • Isabelle Parmentier
  • Hans Pottel
  • Réal Lapointe
  • Sander Ovaere
  • Franky Vansteenkiste
  • Franck Vandenbroucke-Menu
Article

Abstract

Background

Patients with lesions in the posterosuperior (PS) segments of the liver have been considered poor candidates for laparoscopic liver resection (LLR). This study aims to compare short-term outcomes of LLR and open liver resections (OLR) in the PS segments.

Methods

This multicenter study consisted of all patients who underwent LLR in the PS segments and all patients who underwent OLR in the PS segments between October 2011 and July 2016. Laparoscopic cases were case-matched with those who had an identical open procedure during the same period based on tumor location (same segment) and the Brisbane classification of the resection. Demographics, comorbid factors, perioperative outcomes, short-term outcomes, necessity of adjuvant chemotherapy, and the interval between surgery and initiation of adjuvant chemotherapy were compared between the two groups. Data were retrieved from a prospectively maintained electronic database.

Results

Both groups were comparable for age, sex, ASA score, maximum tumor diameter, and number of patients with additional liver resections outside the posterior segments. Operative time was similar in both groups (median 140 min; p = 0.92). Blood loss was less in the LLR-group (median: 150 vs. 300 ml in OLR-group). Median hospital stay was 6 days in both groups. There was no significant difference in postoperative complications (OLR-group: 31.4% vs. LLR-group: 25.7%; p = 0.60). There was no significant difference in R0 resections (LLR: 97.2 vs. 100% in OLR; p = 1.00). Tumor-free margins were less in the LLR group (LLR: 5 vs. 9.5 mm in OLR; p = 0.012). Patients undergoing LLR were treated with chemotherapy sooner compared to those undergoing OLR (41 vs. 56 days, p = 0.02).

Conclusion

This study suggests that laparoscopic parenchymal preserving liver resections in the PS segments can be performed with comparable short-term outcomes as similar OLR. The shorter interval to chemotherapy might provide long-term oncologic benefits in patients who underwent LLR.

Keywords

Hepatobiliary surgery Laparoscopy Posterosuperior segments 

Notes

Compliance with ethical standards

Disclosures

Mathieu D’Hondt, Esther Tamby, Isabelle Boscart, Simon Turcotte, Isabelle Parmentier, Hans Pottel, Réal Lapointe, Sander Ovaere, Franky Vansteenkiste, and Franck Vandenbroucke-Menu have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Mathieu D’Hondt
    • 1
  • Esther Tamby
    • 2
  • Isabelle Boscart
    • 1
  • Simon Turcotte
    • 2
  • Isabelle Parmentier
    • 3
  • Hans Pottel
    • 4
  • Réal Lapointe
    • 2
  • Sander Ovaere
    • 1
  • Franky Vansteenkiste
    • 1
  • Franck Vandenbroucke-Menu
    • 2
  1. 1.Department of Digestive and Hepatobiliary/Pancreatic SurgeryGroeninge HospitalKortrijkBelgium
  2. 2.HPB Surgery and Liver Transplantation UnitCHUM St-Luc, University of MontrealMontrealCanada
  3. 3.Department of Oncology and StatisticsGroeninge Hospital8500 KortrijkBelgium
  4. 4.Interdisciplinary Research CenterCatholic University LeuvenKortrijkBelgium

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