Analysis of perioperative outcomes following laparoscopic repeat liver resection compared to laparoscopic primary liver resection based on a single surgeon's experience: A 1:2 propensity score-matched study

Abstract

Background: We report a single surgeon experience with laparoscopic repeat liver resection (LRLR), and analyse short-term outcomes relative to laparoscopic primary liver resection (LPLR).

Methods: Two-hundred and twenty-two laparoscopic liver resections were performed from 2012 to 2019 of which 33 were LRLR. 1:2 propensity-score matching was done to compare 32 LRLR with 64 LPLR cohort. We further analyzed the first 16 LRLR cases compared to the subsequent 17 cases.

Results: 32 LRLR cases were matched to 64 LPLR cases. Apart from a higher frequency of Pringle maneuver in the LPLR cohort (p = 0.006), there were no differences in other perioperative outcomes. There were more posterosuperior located tumours (75.0% vs 17.6%, p = 0.003) and higher median difficulty score (8.50 vs 5.00, p = 0.025) in the initial 16 LRLR cases compared to the next 17. The earlier group had higher median blood loss (250.00 ml vs 50.00 ml, p = 0.012), but other outcomes were similar.

Conclusion: LRLR may be safely performed in selected patients with no difference in key perioperative outcomes compared to LPLR.

Keywords: Laparoscopic; Liver resection; Primary; Recurrent; Repeat.