Laparoscopic hepatectomy versus open hepatectomy for hepatocellular carcinoma in 157 patients: A case controlled study with propensity score matching at two Chinese centres

Abstract

Background: The aim of this study was to investigate the long-term outcomes and perioperative outcomes of laparoscopic hepatectomy (LH) versus open hepatectomy (OH) for hepatocellular carcinoma (HCC) between well-matched patient groups.

Methods: We retrospectively reviewed data from 1535 hepatocellular carcinoma patients who underwent liver resection between January 2002 and December 2016 at two Chinese centres. Propensity score matching of patients in a ratio of 1:1 was conducted and 157 patients were matched.

Results: The median blood loss (150 vs 380 ml, P < 0.001) was significantly less with LH. The laparoscopic group had shorter hospital stay (6 vs 10 days, P < 0.001) and less complication rate (6.4% vs 24.2%,P < 0.001). There were no significant differences in overall survival and disease-free survival between LH and OH. There were no significant differences in perioperative and long-term outcomes.

Conclusion: Laparoscopic hepatectomy is technically feasible and safe in selected patients. LH showed similar long-term outcomes, associated with less blood loss, shorter hospital stay, and fewer postoperative complications in selected patients with HCC compared with OH.

Keywords: Hepatectomy; Hepatocellular carcinoma; Laparoscopic; Liver resection; Long-term survival.