A Single Centre Comparative Study of Total Laparoscopic Versus Open Liver Resection of Right Posterior Segments

Purpose: Patients with lesions in the right posterior segments of the liver have been considered technically challenging for laparoscopic liver resection (LLR). The aim of the current study is to compare short-term outcomes of LLR and open liver resections (OLR) of the right posterior segments. Methods: Retrospective review of patients undergoing resection of the right posterior segments of the liver from June 2016 to January 2018 in our tertiary centre. Results: Eighteen patients in each group (LLR and OLR) underwent resection of the right posterior segments. The mean age and gender distribution were comparable between both groups. In four patients (22.2%), conversion to open surgery was indicated. The maximum tumour diameter was comparable between the groups (4.04 ± 2.52cm in LLR versus 3.88± 2.26 in OLR, p=.876). Similar operating times were found in LLR and OLR (244.66 ±79.42 and 220.75 ±102.35 minutes respectively) (p=0.187). There was no difference in intraoperative blood loss (p=0.539), duration of Pringle manoeuvre (p=0.157) and resection margins (p=0.114). Postoperative complications were comparable using Dindo-Clavien classification. Length of stay (LOS) was shorter following LLR (4.8 ± 1.72 versus 9.0 ± 3.9 days in the OLR, p<0.0005). Conclusion: LLR for carefully selected patients with lesions in the right posterior segments is safe and feasible with similar short-term outcomes and shorter LOS compared to the OLR group.