Efficacy of laparoscopic hepatectomy in patients with liver cirrhosis

Hepatectomy in patients with liver cirrhosis is associated with a higher rate of complications. The purpose of this study was to evaluate the efficacy of laparoscopic hepatectomy in cirrhotic patients.

We introduced laparoscopic hepatectomy in our institution in April 2014. We performed 53 procedures on patients with cirrhosis from April 2014 to May 2017. Open hepatectomy was performed on 68 patients with cirrhosis from January 2010 to May 2017. This study retrospectively analyzed and compared the patient characteristics, perioperative factors, and short-term outcomes in the two groups.

There were no conversions to open surgery in the laparoscopic hepatectomy group. With respect to patient characteristics, this group had significantly higher body mass index (p < 0.001), more patients with a past history of abdominal surgery (p < 0.021), and more patients with a past history of transarterial chemoembolization or radiofrequency ablation (p = 0.006). Regarding the short-term outcomes, the operation times were comparable (p = 0.709). The laparoscopic hepatectomy group had less blood loss (median 5 ml vs. 449.5 ml; p < 0.001), lower rate of intraoperative transfusions (1.9% vs. 22.1%; p = 0.001), and shorter postoperative hospital stays (median 7 days vs. 10 days; p < 0.001). The other results, including severe postoperative complications and mortality, were comparable.

Laparoscopic hepatectomy is a useful and viable option in patients with cirrhosis.