Analysis of recent open and laparoscopic liver resections in a German high-volume liver tumor center

Background/aims Minimally invasive treatment modalities of liver tumors remain a matter of development. This study aims to compare the surgical results and postoperative outcomes of consecutive laparoscopic liver resections (LLR) and open liver resections (OLR) in a German Liver Tumor Center.

Methods A retrospective data analysis of consecutive patients undergoing LLR and OLR was performed.

Results A total of n=231 patients were included in the study. Mean patient age was 62±13 years. 42% (n=98) were treated by minimally invasive surgery. 78% (n=179) of patients were operated for malignant disease and 29% (n=66) had at least one previous upper abdominal surgical intervention. Within the LLR group 62% (n=61) patients received an oncologic tumor resection. With 32% (n=31) hepatocellular carcinoma (HCC) represented the main indication for oncologic LLR, followed by Colorectal Carcinoma Liver Metastases (CRLM) with 13% (n=13) and Cholangiocarcinoma (CCA) with 5% (n=5). Overall morbidity (> Clavien Dindo 3b) was 10% (n=24). Morbidity was especially low in the LLR group 5% (n=5) when compared to the OLR 14% (n=19) group. Likewise, overall mortality 6% (n=13) was very low in the LLR group 1% (n=1) when compared to OLR: 9% (n=12) group. In line, mean overall hospital stay was short (13±13 days). With regard to surgical technique, R0 resection in LLR was achieved in 93% (n=91) when compared to OLR 81% (n=107). Overall R0 resection rate was 86% (n=198).

Conclusions The incidence of complex LLR in our cohort is high. LLR is the preferred surgical strategy for HCC treatment. Satisfactory R0 resection rates, morbidity and mortality rates can be achieved in a high-volume liver tumor center, especially with the application of recently introduced minimally invasive treatment modalities.

Publication History

Article published online:
08 September 2020