Laparoscopic minor liver resections for hepatocellular carcinoma in the posterosuperior segments using the rubber band technique: Outcomes compared with open liver resections

Abstract

Laparoscopic minor liver resections (LLR) of the posterosuperior (PS) segments have been increasingly performed at our institution. The aim of this study was to compare the surgical outcomes of LLR and open minor liver resection (OLR) of hepatocellular carcinoma (HCC) located in the PS segments. We included 113 patients: 55 who underwent LLR, and 58 OLR for HCC in the PS segments from January 2008 to August 2019. Propensity score matching in a 1:1 ratio was conducted. The perioperative and long-term outcomes of 37 matched patients were retrospectively analyzed. There was no intra-operative mortality or reoperation in either group. One conversion to open surgery was necessary due to severe post-operative adhesions. The LLR group compared to OLR had statistically significantly shorter operative time (215.16 vs. 251.41 min, p = 0.025), lesser blood loss (218.11 vs. 358.92 mL, p = 0.046), lower complication rate (8.1% vs. 29.7%, p = 0.018), and shorter hospital stay (7.03 vs. 11.78 days, p = 0.001). Intraoperative transfusion, R0 resection, resection margin, 5-year disease-free survival and 5-year overall survival were comparable. Our standardized LLR for HCC in the PS segments provided improved short-term outcomes and similar long-term outcomes compared with OLR.