Pure laparoscopic versus open right hepatectomy for hepatocellular carcinoma in patients with cirrhosis: A propensity-score matched analysis

Abstract

Introduction: We aimed to describe our experience with pure laparoscopic right hepatectomy (LRH) and to compare it with open right hepatectomy (ORH) among hepatocellular carcinoma (HCC) patients with liver cirrhosis. Method: We retrospectively reviewed the medical records of 152 patients who underwent pure LRH (n=37) or ORH (n=115) between June 2008 and July 2015 at Asan Medical Center. We performed 1:1 propensity score (PS) matching between the 2 groups. Subsequently, 33 patients were included in each group. Result: There were no statistically significant differences in intraoperative blood loss (p = 0.612) between both groups. The operative time was longer (median, 297 vs. 176 min; p < 0.0001) and the length of postoperative hospital stay was shorter (median, 9.97 vs. 13.94 days; p ≤ 0.0001) in the laparoscopic group. There were no significant differences in the complications rate, 2-year disease-free survival rate, or 2-year overall survival rate between both groups (p = 0.05, p = 0.645, and p = 0.873, respectively). Conclusion: Even in patients with cirrhosis, complication rate was comparable and the length of hospital stay was shorter with pure LRH than with the traditional open approach. The oncological outcomes of HCC were comparable in both groups. Pure LRH for HCC performed in selected patients appears to represent a viable alternative to ORH.