The differential benefit of laparoscopic over open minor liver resection for lesions situated in the anterolateral or posterosuperior segments

Jasper P Sijberden^#^{1

2

3}, Guido Fiorentini^#⁴, Jacopo Lanari⁵, Davit Aghayan^{6

7}, Daniel Osei-Bordom⁸, Nadia Russolillo⁹, Arjun Takhar¹⁰, Andrea Benedetti Cacciaguerra¹¹, Santi Lopez-Ben¹², Mathieu D'Hondt¹³, Felice Giuliante¹⁴, David Fuks¹⁵, Fernando Rotellar^{16

17}, Andrea Ruzzenente¹⁸, Adnan Alseidi^{19

20}, Mikhail Efanov²¹, Burak Görgec^{2

3}, Giuseppe Zimmitti¹, Enrico Gringeri⁵, Federica Cipriani⁴, Åsmund Avdem Fretland⁶, Ravi Marudanayagam⁸, Marco Vivarelli¹¹, John N Primrose¹⁰, Alessandro Ferrero⁹, Robert P Sutcliffe⁸, Bjørn Edwin⁶, Umberto Cillo⁵, Marc G Besselink^{2

3}, Mohammad Abu Hilal^#^{1

10}, Luca A Aldrighetti^#⁴

Affiliations

¹ Department of Surgery, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy.
² Amsterdam UMC location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.
³ Cancer Center Amsterdam, Amsterdam, the Netherlands.
⁴ Hepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy.
⁵ Department of Surgical, Oncological and Gastroenterological Sciences, General Surgery 2, Hepatobiliary Surgery and Liver Transplantation, Padua University Hospital, Padua, Italy.
⁶ The Intervention Centre and Department of HPB Surgery, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
⁷ Department of Surgery, Ringerike Hospital, Vestre Viken Hospital Trust, Drammen, Norway.
⁸ Liver Unit, Queen Elizabeth Hospital, Birmingham, UK.
⁹ Department of General and Oncological Surgery, Umberto I Mauriziano Hospital, Largo Turati, Turin, Italy.
¹⁰ Department of Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
¹¹ Hepatobiliary and Abdominal Transplantation Surgery, Department of Experimental and Clinical Medicine, Riuniti Hospital, Polytechnic University of Marche, Ancona, Italy.
¹² Servei de Cirurgia General i Digestiva, Hospital Doctor Josep Trueta de Girona, Girona, Catalonia, Spain.
¹³ Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, Kortrijk, Belgium.
¹⁴ Chirurgia Epatobiliare, Università Cattolica del Sacro Cuore-IRCCS, Rome, Italy.
¹⁵ Department of Digestive, Oncologic and Metabolic Surgery, Institut Mutualiste Montsouris, Université Paris Descartes, Paris, France.
¹⁶ HPB and Liver Transplantation Unit, Department of Surgery, University Clinic, Universidad de Navarra, Navarra, Spain.
¹⁷ Institute of Health Research of Navarra (IdisNA), Pamplona, Spain.
¹⁸ Department of Surgery, University of Verona, Verona, Italy.
¹⁹ Department of Surgery, Virginia Mason Medical Center, Seattle, WA, USA.
²⁰ Department of Surgery, University of California San Francisco, San Francisco, CA, USA.
²¹ Department of Hepato-Pancreato-Biliary Surgery, Moscow Clinical Research Centre, Moscow, Russia.

^# Contributed equally.

PMID: 39175716
PMCID: PMC11336523
DOI: 10.21037/hbsn-23-494

The differential benefit of laparoscopic over open minor liver resection for lesions situated in the anterolateral or posterosuperior segments

Jasper P Sijberden et al. Hepatobiliary Surg Nutr. 2024.

. 2024 Aug 1;13(4):604-615.

doi: 10.21037/hbsn-23-494. Epub 2024 Jul 4.

Authors

Affiliations

¹ Department of Surgery, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy.
² Amsterdam UMC location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.
³ Cancer Center Amsterdam, Amsterdam, the Netherlands.
⁴ Hepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy.
⁵ Department of Surgical, Oncological and Gastroenterological Sciences, General Surgery 2, Hepatobiliary Surgery and Liver Transplantation, Padua University Hospital, Padua, Italy.
⁶ The Intervention Centre and Department of HPB Surgery, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
⁷ Department of Surgery, Ringerike Hospital, Vestre Viken Hospital Trust, Drammen, Norway.
⁸ Liver Unit, Queen Elizabeth Hospital, Birmingham, UK.
⁹ Department of General and Oncological Surgery, Umberto I Mauriziano Hospital, Largo Turati, Turin, Italy.
¹⁰ Department of Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
¹¹ Hepatobiliary and Abdominal Transplantation Surgery, Department of Experimental and Clinical Medicine, Riuniti Hospital, Polytechnic University of Marche, Ancona, Italy.
¹² Servei de Cirurgia General i Digestiva, Hospital Doctor Josep Trueta de Girona, Girona, Catalonia, Spain.
¹³ Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, Kortrijk, Belgium.
¹⁴ Chirurgia Epatobiliare, Università Cattolica del Sacro Cuore-IRCCS, Rome, Italy.
¹⁵ Department of Digestive, Oncologic and Metabolic Surgery, Institut Mutualiste Montsouris, Université Paris Descartes, Paris, France.
¹⁶ HPB and Liver Transplantation Unit, Department of Surgery, University Clinic, Universidad de Navarra, Navarra, Spain.
¹⁷ Institute of Health Research of Navarra (IdisNA), Pamplona, Spain.
¹⁸ Department of Surgery, University of Verona, Verona, Italy.
¹⁹ Department of Surgery, Virginia Mason Medical Center, Seattle, WA, USA.
²⁰ Department of Surgery, University of California San Francisco, San Francisco, CA, USA.
²¹ Department of Hepato-Pancreato-Biliary Surgery, Moscow Clinical Research Centre, Moscow, Russia.

^# Contributed equally.

PMID: 39175716
PMCID: PMC11336523
DOI: 10.21037/hbsn-23-494

Abstract

Background: It is well known that laparoscopic liver surgery can offer advantages over open liver surgery in selected patients. However, what type of procedures can benefit most from a laparoscopic approach has been investigated poorly thus far. The aim of this study is thus to define the extent of advantages of laparoscopic over open liver surgery for lesions in the anterolateral (AL) and posterosuperior (PS) segments.

Methods: In this international multicentre retrospective cohort study, laparoscopic and open minor liver resections for lesions in the AL and PS segments were compared after propensity score matching. The differential benefit of laparoscopy over open liver surgery, calculated using bootstrap sampling, was compared between AL and PS resections and expressed as a Delta of the differences.

Results: After matching, 3,040 AL and 2,336 PS resections were compared, encompassing open and laparoscopic procedures in a 1:1 ratio. AL and PS laparoscopic liver resections were more advantageous in comparison to open in terms of blood loss, transfusion rate, complications, and length of stay. However, AL resections benefitted more from laparoscopy than PS in terms of overall and severe complications (D-difference were 4.8%, P=0.046 and 3%, P=0.046) and blood loss (D-difference was 195 mL, P<0.001). Similar results were observed in the subset for high-volume centres, while in recent years no significant differences were found in the differential benefit between AL and PS segments.

Conclusions: The advantage of laparoscopic over open liver surgery is greater in the AL segments than in the PS segments.

Keywords: Liver neoplasms; hepatectomy; laparoscopic liver resection; open liver resection.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://hbsn.amegroups.com/article/view/10.21037/hbsn-23-494/coif). M.A.H. and L.A.A. serve as unpaid editorial board members of HepatoBiliary Surgery and Nutrition. Outside of the submitted work, S.L.B. reported payment or honoraria from Baxter, Olympus, Siemens and Johnson & Johnson, and A.A.F. reported speaker’s honoraria from Bayer and Olympus. The other authors have no conflicts of interest to declare.

Figures

**Figure 1**
Differential benefit of laparoscopy in the AL and PS segments in the complete cohort. CI, confidence interval; AL, anterolateral; PS, posterosuperior.

See this image and copyright information in PMC

References

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The differential benefit of laparoscopic over open minor liver resection for lesions situated in the anterolateral or posterosuperior segments

Affiliations

The differential benefit of laparoscopic over open minor liver resection for lesions situated in the anterolateral or posterosuperior segments

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

LinkOut - more resources

Full Text Sources