Laparoscopic Hepatectomy is a Feasible and Safe Choice for Primary Hepatocellular Carcinoma

Abstract

Introduction: Laparoscopic hepatectomy (LH) for hepatocellular carcinoma (HCC) is well-known for its advantages but its specific long-term outcomes are unknown. This study aimed to analyze the perioperative, short-term, and long-term outcomes between LH and open hepatectomy (OH) for primary HCC who underwent LH during the developing period of LH in a single center. Methods: This retrospective study included patients diagnosed with primary HCC who underwent hepatectomy between January 2013 and December 2019. The patients were divided into the LH (n=63) and OH (n=96) groups. Demographic and perioperative data were collected. Results: A higher percentage of patients in the OH group underwent major resection (38.5% vs. 11.1%, p < 0.001). The operative time was 47 minutes shorter and the intraoperative blood loss was 105 mL less in the LH group. The major postoperative complication rate (33.3% vs. 50.0%, p = 0.05) and the 90-day readmission rate (3.2% vs. 12.5%, p = 0.048) were lower in the LH group. The overall survival and disease-free survival were similar between the two groups. Conclusions: LH is a feasible and safe alternative for primary HCC, with less blood loss, fewer major complications, and shorter postoperative hospital stay. LH does not worsen short- or long-term outcomes.