Laparoscopic versus open major liver resection for hepatocellular carcinoma: a case-matched analysis of short- and long-term outcomes

Background: The feasibility and safety of laparoscopic major hepatectomy (LMH) is still uncertain. The purpose of the present study is to compare the short- and long-term outcomes of LMH with those of open major hepatectomy (OMH) for hepatocellular carcinoma (HCC). Method: Between January 2012 and December 2018, a total of 26 patients received laparoscopic major hepatectomy in our center. To minimize any confounding factors, a 1:3 case-matched analysis was conducted based on the demographics and extent of liver resection. Data of demographics, perioperative outcomes and long-term oncologic outcomes were reviewed. Results: : Intraoperative blood loss ( P =0.007) were significantly lower in LMH group. In addition, LMH group exhibited a lower overall complication rate ( P =0.039) and shorter postoperative hospital stay ( P =0.024). However, no statistically significant difference was found between LMH and OMH regarding operation time ( P =0.215) and overall cost ( P =0.024). Two laparoscopic cases were converted to open liver resection. In regard with long-term outcomes, there was no significant difference between LMH and OMH regarding disease-free survival (DFS) ( P =0.079) and overall survival (OS) ( P =0.172). Conclusion: LMH can be an effective and safe alternative to OMH for selected patients with liver cancer in short- and long-term outcomes.