Abstract
BackgroundData on surgical outcomes of laparoscopic liver resection (LLR) versus open liver resection (OLR) of benign liver tumour (BLT) are scarce. This study aimed to provide a nationwide overview of postoperative outcomes after LLR and OLR of BLT. MethodsThis was a nationwide retrospective study including all patients who underwent liver resection for hepatocellular adenoma, haemangioma and focal nodular hyperplasia in the Netherlands from 2014 to 2019. Propensity score matching (PSM) was applied to compare 30-day overall and major morbidity and 30-day mortality after OLR and LLR. ResultsIn total, 415 patients underwent BLT resection of whom 230 (55.4%) underwent LLR. PSM for OLR and LLR resulted in 250 matched patients. Median (IQR) length of stay was shorter after LLR than OLR (4 versus 6 days, 5.0–8.0, p < 0.001). Postoperative 30-day overall morbidity was lower after LLR than OLR (12.0% vs. 22.4%, p = 0.043). LLR was associated with reduced 30-day overall morbidity in multivariable analysis (aOR:0.46, CI:0.22–0.95, p = 0.043). Both 30-day major morbidity and 30-day mortality were not different. ConclusionsLLR for BLT is associated with shorter hospital stay and reduced overall morbidity and is preferred if technically feasible.
Highlights
The role of liver resection in the treatment of benign liver tumours (BLT) remains challenging.[1,2] Indications for resection differ per tumour type as clinical implications across BLT types vary significantly.[2]
The majority of BLT are comprised of hepatocellular adenoma (HCA), haemangioma, and focal nodular hyperplasia (FNH).[3]
HCAs are associated with long term oral contraceptive pill use and obesity.[5,6]
Summary
The role of liver resection in the treatment of benign liver tumours (BLT) remains challenging.[1,2] Indications for resection differ per tumour type as clinical implications across BLT (sub) types vary significantly.[2]. Current guidelines advocate surgery if tumour size remains 50 mm[2] This period, though, may be too short for large HCAs to regress to sub-50mm size.[11]. Propensity score matching (PSM) was applied to compare 30-day overall and major morbidity and 30-day mortality after OLR and LLR. Postoperative 30-day overall morbidity was lower after LLR than OLR (12.0% vs 22.4%, p = 0.043). LLR was associated with reduced 30-day overall morbidity in multivariable analysis (aOR:0.46, CI:0.22–0.95, p = 0.043). Both 30-day major morbidity and 30-day mortality were not different. Conclusions: LLR for BLT is associated with shorter hospital stay and reduced overall morbidity and is preferred if technically feasible
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