A meta-analysis: laparoscopic versus open liver resection for large hepatocellular carcinoma

Abstract

Background The indication of laparoscopic liver resection (LLR) for treating large hepatocellular carcinoma (HCC) is controversial. In this study, we compared the short-term and long-term outcomes of LLR and open liver resection (OLR) for large HCC. Material and methods We searched eligible articles about LLR versus OLR for large HCC in PubMed, Cochrane Library, and EMBASE and performed a meta-analysis. Results Eight publications involving 1,338 patients were included. Among them, 495 underwent LLR and 843 underwent OLR. The operation time was longer in the LLR group (MD: 22.23, 95% CI: 4.14–40.33, p = 0.02). but the postoperative hospital stay time was significantly shorter (MD : −4.88, CI: −5.55 to −4.23, p < 0.00001), and the incidence of total postoperative complications and major complications were significantly fewer (OR: 0.49, 95% CI:0.37–0.66, p < 0.00001; OR: 0.54, 95% CI:0.36 − 0.82, p = 0.003, respectively). Patients in the laparoscopic group had no significant difference in intraoperative blood loss, intraoperative transfusion rate, resection margin size, R0 resection rate, three-year overall survival (OS) and three-year disease-free survival (DFS). Conclusion LLR for large HCC is safe and feasible. This surgical strategy will not affect the long-term outcomes of patients.