Short-term and middle-term evaluation of laparoscopic hepatectomies compared with open hepatectomies: A propensity score matching analysis

Table 1 Demographic data and preoperative variables before and after propensity score matching n (%)

	OLR (n = 169)	LLR (n = 72)	P value	OLR (n = 72)	LLR (n = 72)	P value
Gender (M:F)	106:63	35:37	0.042	37:35	35:37	0.739
Age (yr), median (IQR)	65 (58-71)	61 (49-71)	0.091	62 (52-67)	61 (49-71)	0.794
BMI (kg/m2), median (IQR)
< 30	141 (83.74)	58 (80.6)	0.590	58 (80.6)	59 (81.9)	0.831
> 30	28 (16.6)	14 (19.4)		14 (19.4)	13 (18.1)
Co-morbidities	114 (67.5)	39 (54.2)	0.0499	43 (59.7)	39 (54.2)	0.501
Dyslipidemia	53 (31.4)	16 (22.2)	0.151	20 (27.8)	16 (22.2)	0.441
Diabetes	27 (16.0)	12 (16.7)	0.894	10 (13.9)	12 (16.7)	0.643
Hypertension	60 (35.5)	28 (38.9)	0.617	24 (33.3)	28 (38.9)	0.488
Deep venous thrombosis/pulmonary embolism	20 (11.8)	6 (8.3)	0.423	6 (8.3)	6 (8.3)	1
Arteriopathy	8 (4.7)	3 (4.2)	1	1 (1.4)	3 (4.2)	0.620
Renal failure	7 (4.1)	1 (1.4)	0.442	1 (1.4)	1 (1.4)	1
Hepatopathy	22 (13.0)	26 (36.1)	< 0.001	14 (19.4)	26 (36.1)	0.026
Cirrhosis	18 (10.7)	21 (29.2)	0.002	10 (13.9)	21 (29.2)	0.067
Steatosis	11 (6.5)	4 (5.6)		3 (4.2)	4 (5.6)
Sains	140 (82.8)	47 (65.3)		59 (81.9)	47 (65.3)
Cardiopathy	35 (20.7)	9 (12.5)	0.131	10 (13.9)	9 (12.5)	0.806
Arrhythmia-atrial fibrillation	9 (5.3)	3 (4.2)	1	2 (2.8)	3 (4.2)	1
COPD	13 (7.7)	11 (15.3)	0.072	2 (2.8)	11 (15.3)	0.02
ASA score (I/II/III) (n)	36/82/51	26/28/18	0.055	21/34/17	26/28/18	0.565
ASA1 + 2	118 (69.8)	54 (75.0)	0.416	55 (76.4)	54 (75.0)	1
ASA3 + 4	51 (30.2)	18 (25.0)	0.416	17 (23.6)	18 (25.0)	1
Preoperative chemotherapy	101 (59.8)	26 (36.1)	< 0.001	30 (41.7)	26 (36.1)	0.494
Number of nodules, median (IQR)	3.0 (1.0-5.0)	1.0 (1.0-1.0)	< 0.001	1.5 (1.0-2.0)	1.0 (1.0-1.0)	< 0.001
Nodule max. size (mm), mean (IQR)	30.0 (20.0-45.0)	26.5 (20.0-44.3)	0.352	26.5 (20.0-44.3)	30.0 (20.0-55.3)	0.138
Resection type
Major resection	69 (40.8)	9 (12.5)	< 0.001	15 (20.8)	9 (12.5)	0.180
Minor resection	100 (59.2)	63 (87.5)		57 (79.2)	63 (87.5)
Benign lesions
Adenoma	3 (1.8)	9 (12.5)	0.001	3 (4.2)	9 (12.5)	0.129
Nodular hyperplasia	2 (1.2)	3 (4.2)	0.159	2 (2.8)	3 (4.2)	1
Hydatid cysts	5 (3.0)	2 (2.8)	1	3 (4.2)	2 (2.8)	1
Angioma	1 (0.6)	0 (0.0)	1	0 (0.0)	0 (0.0)	1
Other pathologies (Caroli disease, sclerosing cholangitis, traumatic, etc.)	2 (1.2)	2 (2.8)	0.585	2 (2.8)	2 (2.8)	1
Malignant tumors
Hepatocellular carcinoma	25 (14.8)	24 (33.3)	0.001	11 (15.3)	24 (33.3)	0.012
Colorectal metastases	101 (59.8)	18 (25.0)	< 0.001	38 (52.8)	18 (25.0)	< 0.001
Cholangiocarcinoma	11 (6.5)	5 (6.9)	1	4 (5.6)	5 (6.9)	1
Gallbladder cancer	1 (0.6)	0 (0.0)	1	0 (0.0)	0 (0.0)	1
Klatskin tumor	2 (1.2)	1 (1.4)	1	2 (2.8)	1 (1.4)	1
Neuroendocrine tumors	7 (4.1)	1 (1.4)	0.442	5 (6.9)	1 (1.4)	0.209
Other types of metastasis	25 (14.8)	24 (33.3)	0.001	11 (15.3)	24 (33.3)	0.012
Preoperative blood test, median (IQR)
Albumin (g/dL)	40.0 (38.0-43.0)	41.0 (39.0-44.0)	0.293	40.5 (38.0-44.0)	41.0 (39.0-44.3)	0.465

OLR: Open liver resection; LLR: Laparoscopic liver resection; ASA: American Society of Anesthesiologists; COPD: Chronic obstructive pulmonary disease.

Table 2 Operative and postoperative data before and after propensity score matching n (%)

	OLR (n = 169)	LLR (n = 72)	P value	OLR (n = 72)	LLR (n = 72)	P value
Resection type
Bisegmentectomy	46 (27.2)	10 (13.9)	0.025	30 (41.7)	10 (13.9)	< 0.001
Segmentectomy	12 (7.1)	29 (40.3)	< 0.001	8 (11.1)	29 (40.3)	< 0.001
Wedge resection	49 (29.0)	24 (33.3)	0.502	20 (27.8)	24 (33.3)	0.469
Left hepatectomy	23 (13.6)	5 (6.9)	0.188	8 (11.1)	5 (6.9)	0.383
Right hepatectomy	26 (15.4)	3 (4.2)	0.014	6 (8.3)	3 (4.2)	0.494
Enlarged right hepatectomy	15 (8.9)	1 (1.4)	0.044	2 (2.8)	1 (1.4)	1
Combined resection and radiofrequency	54 (32.0)	9 (12.5)	0.002	13 (18.1)	9 (12.5)	0.354
Number of resected segments, median (IQR)	2.0 (0.0-4.0)	1.0 (0.0-1.3)	< 0.001	2.0 (0.0-2.0)	1.0 (0.0-1.3)	0.004
Operation length (min), median (IQR)	250 (190-330)	185 (150-254)	< 0.001	247.5 (187.5-332.5)	185.0 (150.0-253.8)	0.002
Pedicular clamping	110 (65.1)	40 (55.6)	0.162	43 (59.7)	40 (55.6)	0.613
Intermittent	96 (56.8)	34 (47.2)	0.354	36 (50.0)	34 (47.2)	0.739
Permanent	14 (8.3)	6 (8.3)		7 (9.7)	6 (8.3)	0.771
No clamping	59 (34.9)	32 (44.4)		29 (40.3)	32 (44.4)	0.613
Clamping duration (min), median (IQR)	22.0 (0.0-38.0)	15.0 (0.0-35.0)	0.174	25.0 (0.0-36.5)	15.0 (0.0-35.0)	0.411
Blood loss (mL), median (IQR)	300 (30-500)	100 (30-356)	0.003	300.0 (30.0-562.5)	100.0 (30.0-356.3)	0.002
Transfusion (n), median (IQR)	41 (24.3)	12 (16.7)	0.193	16 (22.2)	12 (16.7)	0.400
Length of hospital stay (d), median (IQR)	10.0 (7.0-14.0)	7.0 (5.8-10.0)	< 0.001	9.0 (7.0-12.0)	7.0 (5.8-10.0)	0.004
R0 resection margin	139 (82.3)	63 (87.5)	0.311	62 (86.1)	63 (87.5)	0.806
Conversion rate	NA	7 (9.7)	0.065	NA	7 (9.7)	0.326
Postoperative complications ≥ 1
Respiratory	30 (17.8)	6 (8.3)	0.060	18 (25.0)	6 (8.3)	0.007
Atelectasis	21 (12.4)	4 (5.6)	0.109	11 (15.3)	4 (5.6)	0.056
Pneumopathy	10 (5.9)	2 (2.8)	0.518	7 (9.7)	2 (2.8)	0.166
Renal	7 (4.1	0 (0.0)	0.107	5 (6.9)	0 (0.0)	0.058
Acute renal failure	6 (3.6)	0 (0.0)	0.183	5 (6.9)	0 (0.0)	0.058
Cystitis/pyelonephritis	1 (0.6)	0 (0.0)	1	0 (0.0)	0 (0.0)	1
Cardiovascular	7 (4.1)	4 (5.6)	0.737	2 (2.8)	4 (5.6)	0.681
Wall infection	8 (4.7)	2 (2.8)	0.728	6 (8.3)	2 (2.8)	0.275
Deep collection	19 (11.2)	6 (8.3)	0.498	8 (11.1)	6 (8.3)	0.574
Hemorrhage	3 (1.8)	0 (0.0)	0.556	2 (2.8)	0 (0.0)	0.497
Liver failure	7 (4.1)	1 (1.4)	0.442	4 (5.6)	1 (1.4)	0.366
Ascites	5 (3.0)	2 (2.8)	1	5 (6.9)	2 (2.8)	0.441
Biliary fistula	10 (5.9)	2 (2.8)	0.518	1 (1.4)	2 (2.8)	1
Medical complications	47 (27.8)	3 (4.3)	< 0.001	19 (26.4)	3 (4.3)	< 0.001
Surgical complications	7 (4.1)	2 (2.8)	0.729	4 (5.6)	2 (2.8)	0.681
I-II	47 (27.8)	21 (29.2)	0.690	21 (29.2)	21 (29.2)	0.447
III-IV	33 (19.5)	12 (16.7)		13 (18.1)	12 (16.7)
V	4 (2.4)	0 (0.0)		3 (4.2)	0 (0.0)
Postoperative mortality 30 d	2 (1.2)	0 (0.0)	1	2 (1.2)	0 (0.0)	0.080
Postoperative mortality 60 d	3 (1.8)	0 (0.0)	0.556	0 (0.0)	0 (0.0)	1
Postoperative mortality 90 d	5 (3.0)	0 (0.0)	0.326	0 (0.0)	0 (0.0)	1

OLR: Open liver resection; LLR: Laparoscopic liver resection.