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Pure laparoscopic liver resection reduces surgical site infections and hospital stay. Results of a case-matched control study in 50 patients

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Abstract

Background

Laparoscopic resection is an emerging tool in surgical oncology, but its role in liver tumors is far from being universally accepted.

Methods

We designed a case-matched control study, comparing laparoscopic (LAP) vs. open hepatectomies (OP) performed in the same center during the same period of time.

Fifty LAP were performed (34 liver metastases, 7 hepatocellular carcinomas, 2 hydatid cysts, and 5 benign tumors). Cases were compared with 100 OP matched according to: diagnosis, number of lesions, type of resection, age, ASA score, and ECOG performance status. We evaluated intraoperative and postoperative parameters, focusing on morbidity and mortality.

Results

Preoperative data were comparable in both groups. Operative features were similar in terms of overall morbidity 18 (36 %) vs. 36 (36 %), p = 1; intraoperative bleeding, 401 (18–2192) vs. 475 (20–2000) mL, p = 0.89; pedicle clamping, 37 (74 %) vs. 88 (88 %), p = 0.55; margin, 0.6 (0–5) vs. 0.65 (0–5) cm, p = 0.94, and mortality p = 0.65 for the LAP and OP groups, respectively. There was a significant decrease in surgical site infections 1 (2 %) vs. 18 (18 %) p = 0.007 in the LAP group. Operative time was longer: 295 (120–600) vs. 200 (70–450) min (p = 0.0001), and hospital stay significantly shorter: 4 (1–60) vs. 7 (3–44) days, p = 0.0001 with less readmissions (0 vs. 7 %) in the LAP.

Discussion

In adequately selected patients, laparoscopic hepatectomy is feasible, safe, shortens hospital stay, and decreases surgical site infections.

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Acknowledgements

Fernando Rotellar (University of Navarra), for reviewing the manuscript.

Conflicts of interest

Drs. López-Ben, Palacios, Codina-Barreras, Albiol, Falgueras, Castro, and Figueras have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Hepato-biliary and Pancreatic Surgery Unit, Department of Surgery, “Doctor Josep Trueta” Hospital, Biomedical Institute of Research, IdIBGi, Girona, Spain

    Santiago López-Ben, Antonio Codina-Barreras, M. Teresa Albiol, Laia Falgueras, Ernesto Castro & Joan Figueras

  2. CES University, Medellín, Colombia

    Oscar Palacios

  3. HPB Unit, General and Digestive Surgery Department, Hospital “Doctor Josep Trueta”, Crta de França s/n, 17007, Girona, Spain

    Santiago López-Ben

Authors
  1. Santiago López-Ben
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  2. Oscar Palacios
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  3. Antonio Codina-Barreras
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  4. M. Teresa Albiol
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  5. Laia Falgueras
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  6. Ernesto Castro
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  7. Joan Figueras
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Correspondence to Santiago López-Ben.

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López-Ben, S., Palacios, O., Codina-Barreras, A. et al. Pure laparoscopic liver resection reduces surgical site infections and hospital stay. Results of a case-matched control study in 50 patients. Langenbecks Arch Surg 399, 307–314 (2014). https://doi.org/10.1007/s00423-014-1169-7

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  • DOI: https://doi.org/10.1007/s00423-014-1169-7

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