Abstract
Laparoscopic hepatectomy (LH) has been accepted widely owing to its advantages as a minimally invasive surgery; however, laparoscopic right hemihepatectomy (LRH) has rarely been reported. We aimed to compare the benefits and drawbacks of LRH and open approaches. Between January 2014 and October 2017, 85 patients with tumor and hepatolithiasis who underwent LRH (n = 30) and open right hemihepatectomy (ORH) (n = 55) were enrolled in this study. For tumors, LRH showed significantly better results with respect to blood loss (P = 0.024) and duration of hospital stay (P = 0.008) than ORH, while hospital expenses (P = 0.031) and bile leakage rate (P = 0.012) were higher with LRH. However, the operative time and rate of other complications were not significantly different between the two groups. However, for hepatolithiasis, there was less blood loss (P = 0.015) and longer operative time (P = 0.036) with LRH than with ORH. There were no significant difference between LRH and ORH in terms of hospital stay, hospital expenses, and complication rate (P > 0.05). Moreover, the postoperative white blood cell count, alanine aminotransferase level, aspartate aminotransferase level, and total bilirubin were not significantly different in both types of patients (P > 0.05). Our results suggest the safety and feasibility of laparoscopy technology for right hemihepatectomy in both tumor and hepatolithiasis patients.
Highlights
Laparoscopic hepatectomy (LH) has been accepted widely owing to its advantages as a minimally invasive surgery; laparoscopic right hemihepatectomy (LRH) has rarely been reported
Our results suggest that LRH offers several advantages over open right hemihepatectomy (ORH), including reduced blood loss, lower hospital stay, and fewer complications
Our results show that LRH is associated with a longer operative time, but less blood loss and shorter hospital stay than ORH
Summary
Laparoscopic hepatectomy (LH) has been accepted widely owing to its advantages as a minimally invasive surgery; laparoscopic right hemihepatectomy (LRH) has rarely been reported. Between January 2014 and October 2017, 85 patients with tumor and hepatolithiasis who underwent LRH (n = 30) and open right hemihepatectomy (ORH) (n = 55) were enrolled in this study. Our results suggest the safety and feasibility of laparoscopy technology for right hemihepatectomy in both tumor and hepatolithiasis patients. The right liver is located deep in the abdominal cavity, and mobilization and exposure remain difficult due to the lack of a smooth and safe liver retractor[12,13]. These anatomical features of the right liver present an unfavorable condition for laparoscopy. The present study aimed to compare the clinical and economic impact of LRH and ORH in both benign and malignant lesions
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