Laparoscopic hepatectomy is superior to open procedures for hepatic hemangioma

Hepatobiliary Pancreat Dis Int. 2021 Apr;20(2):142-146. doi: 10.1016/j.hbpd.2020.09.001. Epub 2020 Sep 13.

Abstract

Background: Laparoscopic hepatectomy (LH) has become increasingly popular for liver neoplasms, but its safety and effectiveness remain controversial. Hepatic hemangiomas are the most common benign liver neoplasm; the main approaches to hepatic hemangiomas include open hepatectomy (OH) and LH. In this study, we compared early outcomes between patients undergoing OH and those with LH.

Methods: Patients underwent OH or LH in our hospital for hepatic hemangiomas between December 2013 and December 2017 were enrolled. All patients underwent comprehensive preoperative evaluations. The clinicopathological index and risk factors of hemangioma resection were assessed.

Results: In total, 41 patients underwent OH while 53 underwent LH. There was no significant difference in any preoperative clinical variables, including liver function, prothrombin time, or platelet count. Hepatic portal occlusion time and operative time were 39.74 vs. 38.35 minutes (P = 0.717) and 197.20 vs. 203.68 minutes (P = 0.652) in the OH and LH groups, respectively. No mortality nor significant perioperative complications were observed between the two groups. In LH group, two cases were converted to OH, one for an oversized tumor and the other for hemorrhage. Compared with OH patients, those with LH had less blood loss (361.69 vs. 437.81 mL, P = 0.024), shorter postoperative hospital stay (7.98 vs. 11.07 days, P = 0.001), and lower postoperative C-reactive protein (43.63 vs. 58.21 mg/L, P = 0.026).

Conclusions: LH is superior to OH in terms of postoperative recovery and blood loss for selected patients with hepatic hemangioma.

Keywords: Hepatic hemangioma; Laparoscopic hepatectomy; Open hepatectomy; Prognosis.

MeSH terms

  • Blood Loss, Surgical
  • Hemangioma* / surgery
  • Hepatectomy / adverse effects
  • Humans
  • Laparoscopy* / adverse effects
  • Length of Stay
  • Liver Neoplasms* / surgery
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Treatment Outcome