The Rate of Postoperative Bile Leak in Minimally Invasive Liver Resection in Comparison With Open Surgery: A Systematic Review

Abstract

The rapid advances in laparoscopic surgery have meant that formerly complex techniques are now commonly performed via this method. These practices are now becoming increasingly popular in the discipline of hepatopancreaticobiliary (HPB) surgery. One such example is liver resection, which is the focus of our review. We aimed to assess the rate of bile leak complications in minimally invasive liver resection compared to an open liver approach in malignant and benign conditions. A systematic review spanning the period from 2000 to 2022 was conducted, examining the postoperative complications in laparoscopic versus open liver resections. We searched the databases Medline, Cochrane, PubMed, and Google Scholar for relevant studies; 16 studies were included in the final analysis. Ten out of 16 studies that were included indicated that there was no significant difference in the rate of bile leaks. Five studies showed that bile leaks were found to occur more frequently in open surgery, and one study suggested that the rates were more common with the laparoscopic approach. The overall comparison of bile leak rates following open and minimally invasive liver resection suggests that there is no reduction in this complication in both types of surgery. As such, a laparoscopic or open method can both be adopted without any concerns for this particular complication.

Keywords: hepatectomy; hepatobiliary surgery; laparoscopic liver resection; open liver resection; post-operative complications.

Figure 1. PRISMA diagram depicting the search strategy

PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses