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Open versus laparoscopic liver resection: looking beyond the immediate postoperative period

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Abstract

Background

Laparoscopic liver resection for malignant disease has shown short-term benefit. This study aimed to compare in-house, 30-day, and 1-year morbidity between laparoscopic and open liver resections.

Methods

The charts for all patients who underwent liver resection for malignant disease between April 2006 and October 2009 were reviewed. Patient, operative, and outcomes data at 30 days and 1 year were collected.

Results

For 76 patients, 49 open and 27 laparoscopic resections were performed. The two groups were similar in terms of age, gender, body mass index (BMI), extent of liver resection, use of ablation therapy, and tumor pathology (P > 0.05). The laparoscopic group had less blood loss (P = 0.004) and shorter hospital stays (P = 0.002). During their hospital stay, patients treated laparoscopically had fewer complications, but the difference was not significant. Home disposition was similar in the laparoscopic (96%) and open (90%) groups. More patients were readmitted at 30 days (2 vs. 9; P = 0.31) and 1 year (4 vs. 19; P = 0.04) in the open group. The all-cause 1-year mortality rates were similar between the laparoscopic and open groups (14.8% vs. 10.2%).

Conclusion

The benefits of laparoscopic liver resection may extend beyond the initial postoperative period, with fewer readmissions despite shorter hospital stays. This also may suggest lower long-term hospital costs.

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Disclosures

Joshua D. Gustafson, Justin P. Fox, James R. Ouellette, Minia Hellan, Paula Termuhlen, Mary C. McCarthy, and Thavam Thambi-Pillai have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Division of Surgical Oncology, Department of Surgery, Wright State University Boonshoft School of Medicine, One Wyoming Street, WCHE 7000, Dayton, OH, 45409, USA

    Joshua D. Gustafson, Justin P. Fox, James R. Ouellette, Minia Hellan, Paula Termuhlen & Mary C. McCarthy

  2. Department of Surgery, Sanford School of Medicine, University of South Dakota, 1508 W 22nd St., Suite 101, Sioux Falls, SD, 57105, USA

    Thavam Thambi-Pillai

  3. Sanford Transplant Center, 1205 S Grange Avenue, Sioux Falls, SD, 57105, USA

    Thavam Thambi-Pillai

Authors
  1. Joshua D. Gustafson
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  2. Justin P. Fox
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  3. James R. Ouellette
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  4. Minia Hellan
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  5. Paula Termuhlen
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  6. Mary C. McCarthy
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  7. Thavam Thambi-Pillai
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Corresponding author

Correspondence to Thavam Thambi-Pillai.

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Gustafson, J.D., Fox, J.P., Ouellette, J.R. et al. Open versus laparoscopic liver resection: looking beyond the immediate postoperative period. Surg Endosc 26, 468–472 (2012). https://doi.org/10.1007/s00464-011-1902-z

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  • DOI: https://doi.org/10.1007/s00464-011-1902-z

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