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Original Article

Laparoscopic versus Open Liver Resection: A Matched-Pair Case Control Study

Kaori Ito¹, Hiromichi Ito¹, Chandrakanth Are², Peter J. Allen¹, Yuman Fong¹, Ronald P. DeMatteo¹, William R. Jarnagin¹ and Michael I. D’Angelica¹

(1)	Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA

(2)	Surgical Oncology, University of Nebraska Medical Center, Omaha, Nebraska

Received: 30 May 2009 Accepted: 10 August 2009 Published online: 2 September 2009

Abstract

Background Laparoscopic liver resection (LLR) has become an increasingly popular operation; however, its theoretical benefits remain unproven. The aim of this study was to conduct a comparative outcome study between LLR and matched-pair open liver resections (OLR).

Methods Sixty five patients underwent attempted LLR from 1998 through 2008; 52 of which were completed laparoscopically. Patients who underwent OLR prior to 1998 were matched to laparoscopic cases for demographics, comorbidities, diagnosis, tumor characteristics, procedure, and background liver. Perioperative and oncologic outcomes were compared between the two groups. Analyses were performed excluding and including conversion cases.

Results Characteristics were comparable between both groups. LLR was associated with significant reductions in estimated blood loss, frequency of transfusion, frequency of Pringle maneuver, postoperative morbidity, time to recovery, length of hospital stay, and incidence of incisional hernia. For patients with malignant tumors, there were no positive surgical margins or local recurrence in either group and the overall pattern of recurrence was similar.

Conclusion For well-selected patients, LLR is a feasible operation that does not compromise operative or oncologic outcomes. While LLR was associated with some benefits, these can only be definitively proven in a randomized controlled trial.

Keywords Laparoscopic liver resection - Minimal invasive surgery - Case control study

Author contributions

Conception and design: K. Ito, D’Angelica

Acquisition of data: K. Ito, Are

Analysis and interpretation of data: K. Ito, H. Ito, D’Angelica

Drafting of the manuscript: K. Ito, Are, D’Angelica

Critical revision of the manuscript: D’Angelica, H. Ito, Allen, Fong, DeMatteo, Jarnagin

Statistical expertise: K. Ito, H. Ito

Supervision: D’Angelica

This study was presented at the 24th Annual SSAT Research Conference on May 30th, 2009, Chicago, IL and at the 50th Annual SSAT Meeting on June 2, 2009, Chicago, IL.

Michael I. D’Angelica
Email: dangelim@mskcc.org

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