Cut surface biliary complications in open and laparoscopic liver resections

Abstract Background/AimsAim of our study was to analyze surgical parameters and postoperative morbidity with special emphasis on cut surface biliary leakage (BL), after launching a minimally invasive liver resection program at our center.Patients and methodsA prospectively maintained medical database of patients who required liver resection was used for analysis. Exclusion criteria were liver resections with biliodigestive anastomosis. Clinicopathological characteristics and outcomes were analyzed retrospectively.ResultsA total of 141 patients were divided into a group of 47 patients (33.3%) receiving laparoscopic (LLR) and 94 patients (66.7%) undergoing open liver resections (OLR). We performed 62 major OLR (66.0%) and 31 major LLR (66.0%). In comparison with the LLR group, operation time was longer (326 ± 97 minutes vs. 287 ± 133 minutes; P = 0.080) and average blood loss was higher in the OLR group (529 ± 441 mL vs. 356 ± 459 mL; P = 0.052), without showing significancy. In the LLR group, morbidity was significantly lower than in the OLR group (OLR vs. LLR: 19 (20.2 %) vs. 3 (6.4%); P = 0.033). Overall BL rate was 4.3% (N = 6). All BL occurred in patients after OLR and were associated with a significantly longer hospital stay (hospital stay with biliary leakage vs. hospital stay without biliary leakage: 37.3 ± 19.3 days vs. 14.7 ± 11.1 days; P < 0.001).ConclusionThe introduction of different transection techniques in laparoscopic liver resections did not increase morbidity and BL rate.