Laparoscopic access is the modern standard for extended liver resection

Abstract

Objective. To evaluate the safety and early results of laparoscopic extended liver resection in case of focal liver pathology by retrospective comparison with the relevant parameters of a similar open intervention. Materials and methods. The study involved 162 patients who were divided into two groups: Group 1 – 50 patients who underwent laparoscopic extended liver resection, and Group 2 – 112 patients who underwent open extended liver resection. The groups were compared by age structure, sex, body mass index, type of pathology (benign/malignant), as well as by characteristics of surgical intervention and postoperative period. Statistical analysis included a t–test for independent samples, Pearson's chi–square test, and other appropriate methods with the calculation of the confidence level p (parametric criterion). The difference in indicators was considered statistically significant at p < 0.05. Results. Laparoscopic osshire for liver resection was longer (p = 0.0012), but was associated with a lower level of pain according to the visual analog scale (p = 0.02) and fewer bed days to discharge (p = 0.0007) than a similar open intervention. There was no statistically significant difference between the groups in terms of age structure, body mass index, number of liver tumors, blood loss, complication rate, and degree of ischemic liver damage. Conclusions. Laparoscopic extended liver resection is a less invasive method than open liver resection, and patients recover faster after it, although its duration is longer. At the same time, laparoscopic and open intervention had a similar incidence of complications, which indicates acceptable safety and high clinical efficacy of the laparoscopic approach in the treatment of patients with liver disease.