Laparoscopic left lateral liver resection should be a standard operation

Abstract

Background: Laparoscopic liver resection was first performed by Gagner in 1992. In the following years, laparoscopic left lateral liver resection rapidly gained the interest of hepatobiliary surgeons due to the easy accessibility of the left lateral segment. This study aimed to gather and analyze available data from the observational studies that have compared laparoscopic and open left lateral hepatic resections.

Methods: All the studies comparing laparoscopic and open left lateral liver resections were searched on the available databases including Medline, Ovid, Embase, Pubmed, and the Cochrane database. The latest date for the search was 30 January 2010. All the articles were cross-references. The studies comparing left lateral liver resections were included in the metaanalysis. Data was analyzed using Review Manager software version 5.0.

Results: After the literature search, a total of seven studies were included in the metaanalysis, which involved 245 patients: 134 in the laparoscopic group and 111 in the open group. The laparoscopic group was shown to have a lower overall complication rate (0.36; 95% CI, 0.20-0.68) and shorter operative time (48.07 min; 95% CI, 30.93-65.21 min) than the open group (p=0.001), which were not associated with heterogeneity between the studies (p=0.84 and 0.34, respectively). The hospital stay of the laparoscopic group was 4.52 days shorter (95% CI, -8.03 to -1.02) than that of the open group. This difference was significant (p=0.01) but associated with significant heterogeneity between the studies.

Conclusion: Although no randomized controlled trials have compared open and laparoscopic liver resection, this metaanalysis demonstrated that laparoscopic left lateral resection is a safe and feasible option associated with a reduced overall complication rate. The authors conclude that it should be performed routinely in liver centers.