International multicenter propensity score matched study on laparoscopic versus open left lateral sectionectomy

Marcel J. van der Poel, Robert S. Fichtinger, Burak Gorgec, Arab Rawashdeh, Pieter J. Tanis, Olivier R. Busch, Thomas M. van Gulik, Cornelis Verhoef, Marieke T. de Boer, Mathieu D'Hondt, Mohammed A. Hilal, Türkan Terkivatan, Ronald M. van Dam, Marc G. Besselink*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Despite a lack of high-level evidence, current guidelines recommend laparoscopic left lateral sectionectomy (LLLS) as the routine approach over open LLS (OLLS). Randomized studies and propensity score matched studies on LLLS vs OLLS for all indications, including malignancy, are lacking. Methods: This international multicenter propensity score matched retrospective cohort study included consecutive patients undergoing LLLS or OLLS in six centers from three European countries (January 2000–December 2016). Propensity scores were calculated based on nine preoperative variables and LLLS and OLLS were matched in a 1:1 ratio. Short-term operative outcomes were compared using paired tests. Results: A total of 560 patients were included. Out of 200 LLLS, 139 could be matched to 139 OLLS. After matching, baseline characteristics were well balanced. LLLS was associated with shorter operative time (144 (110–200) vs 199 (138–283) minutes, P < 0.001), less blood loss (100 (50–300) vs 350 (100–750) mL, P = 0.005) and a 3-day shorter postoperative hospital stay (4 (3–7) vs 7 (5–9) days, P < 0.001). Conclusion: This international multicenter propensity score matched study confirms the superiority of LLLS over OLLS based on shorter postoperative hospital stay, operative time, and less blood loss thus validating current guideline advice.

Original languageEnglish
Pages (from-to)707-714
Number of pages8
JournalHPB
Volume23
Issue number5
Early online date7 Oct 2020
DOIs
Publication statusPublished - 1 May 2021

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