Skip to main content
SpringerLink
Log in

Comparative analysis of the safety and feasibility of laparoscopic versus open caudate lobe resection

  • Original Article
  • Published:
Langenbeck's Archives of Surgery Aims and scope Submit manuscript

Abstract

Purpose

Laparoscopic hepatectomy has been used widely in liver disease due to its advantages as a minimally invasive surgery. However, laparoscopic caudate lobe resection (LCLR) has been reported rarely. We aimed to investigate the safety and feasibility of LCLR by comparing it with open liver surgery.

Methods

A retrospective study was performed including all patients who underwent LCLR and open caudate lobe resection (OCLR) between January 2015 and August 2019. Twenty-two patients were involved in this study and divided into LCLR (n = 10) and OCLR (n = 12) groups based on preoperative imaging, tumor characteristics, and blood and liver function test. Patient demographic data and intraoperative and postoperative outcomes were compared between the two groups.

Results

There were no significant inter-group differences between gender, age, preoperative liver function, American Society of Anesthesiologists (ASA) grade, and comorbidities (P > 0.05). The LCLR showed significantly less blood loss (50 vs. 300 ml, respectively; P = 0.004), shorter length of hospital stay (15 vs. 16 days, respectively; P = 0.034), and shorter operative time (216.50 vs. 372.78 min, respectively; P = 0.012) than OCLR, but hospital expenses (5.02 vs. 6.50 WanRMB, respectively; P = 0.208) showed no statistical difference between groups. There was no statistical difference in postoperative bile leakage (P = 0.54) and wound infection (P = 0.54) between LCLR and OCLR. Neither LCLR nor OCLR resulted in bleeding or liver failure after operation. There were no deaths.

Conclusion

LCLR is a very useful technology, and it is a feasible choice in selected patients with benign and malignant tumors in the caudate lobe.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Uchida H, Iwashita Y, Tada K, Saga K, Takayama H, Hirashita T, Endo Y, Ohta M, Inomata M (2018) Laparoscopic liver resection in cirrhotic patients with specific reference to a difficulty scoring system. Langenbeck's Arch Surg 403:371–377. https://doi.org/10.1007/s00423-018-1671-4

    Article  Google Scholar 

  2. Lin NC, Nitta H, Wakabayashi G (2013) Laparoscopic major hepatectomy: a systematic literature review and comparison of 3 techniques. Ann Surg 257(2):205–213. https://doi.org/10.1097/SLA.0b013e31827da7fe

    Article  PubMed  Google Scholar 

  3. Yoon YI, Kim KH, Kang SH, Kim WJ, Shin MH, Lee SK, Jung DH, Park GC, Ahn CS, Moon DB, Ha TY, Song GW, Hwang S, Lee SG (2017) Pure laparoscopic versus open right hepatectomy for hepatocellular carcinoma in patients with cirrhosis: a propensity score matched analysis. Ann Surg 265(5):856–863. https://doi.org/10.1097/SLA.0000000000002072

    Article  PubMed  Google Scholar 

  4. Cauchy F, Fuks D, Nomi T, Dokmak S, Scatton O, Schwarz L, Barbier L, Belghiti J, Soubrane O, Gayet B (2016) Benefits of laparoscopy in elderly patients requiring major liver resection. J Am Coll Surg 222(2):174–184. https://doi.org/10.1016/j.jamcollsurg.2015.11.006

    Article  PubMed  Google Scholar 

  5. Dagher I, Proske JM, Carloni A, Richa H, Tranchart H, Franco D (2007) Laparoscopic liver resection: results for 70 patients. Surg Endosc 21:619–624. https://doi.org/10.1007/s00464-006-9137-0

    Article  CAS  PubMed  Google Scholar 

  6. Xie SM, Xiong JJ, Liu XT, Chen HY, Iglesia-Garcia D, Altaf K et al (2017) Laparoscopic versus open liver resection for colorectal liver metastases: a comprehensive systematic review and meta-analysis. Sci Rep 7(1):1012. https://doi.org/10.1038/s41598-017-00978-z

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Nguyen KT, Gamblin TC, Geller DA (2009) World review of laparoscopic liver resection-2,804 patients. Ann Surg 250(5):831–841. https://doi.org/10.1097/SLA.0b013e3181b0c4df

    Article  PubMed  Google Scholar 

  8. Croome KP, Yamashita MH (2010) Laparoscopic vs open hepatic resection for benign and malignant tumors: an updated meta-analysis. Arch Surg 145(11):1109–1118 http://archsurg.ama-assn.org/cgi/content/abstract/145/11/1109

    Article  Google Scholar 

  9. Dagher I, O’Rourke N, Geller DA et al (2009) Laparoscopic major hepatectomy: an evolution in standard of care. Ann Surg 250(5):856–860. https://doi.org/10.1097/SLA.0b013e3181bcaf46

    Article  PubMed  Google Scholar 

  10. Kasai M, Cipriani F, Gayet B, Aldrighetti L, Ratti F, Sarmiento JM, Scatton O, Kim KH, Dagher I, Topal B, Primrose J, Nomi T, Fuks D, Abu Hilal M (2018) Laparoscopic versus open major hepatectomy: a systematic review and meta-analysis of individual patient data. Surgery 163(5):985–995

    Article  Google Scholar 

  11. Cherqui D, Husson E, Hammoud R, Malassagne B, Stéphan F, Bensaid S, Rotman N, Fagniez PL (2000) Laparoscopic liver resections: a feasibility study in 30 patients. Ann Surg 232(6):753–762

    Article  CAS  Google Scholar 

  12. Ratti F, Barkhatov LI, Tomassini F, Cipriani F, Kazaryan AM, Edwin B, Abu Hilal M, Troisi RI, Aldrighetti L (2016) Learning curve of self-taught laparoscopic liver surgeons in left lateral sectionectomy: results from an international multi-institutional analysis on 245 cases. Surg Endosc 30(8):3618–3629. https://doi.org/10.1007/s00464-015-4665-0

    Article  PubMed  Google Scholar 

  13. Liu Z, Ding H, Xiong X, Huang Y (2018) Laparoscopic left lateral hepatic sectionectomy was expected to be the standard for the treatment of left hepatic lobe lesions: a meta-analysis. Medicine (Baltimore) 97(7):e9835. https://doi.org/10.1097/MD.0000000000009835

    Article  Google Scholar 

  14. Peng L, Xiao J, Liu Z, Zhu J, Wan R, Xiao W, Li Y (2017) Laparoscopic left-sided hepatectomy for the treatment of hepatolithiasis: a comparative study with open approach. Int J Surg 40:117–123

    Article  Google Scholar 

  15. Cho HD, Kim KH, Hwang S, Ahn CS, Moon DB, Ha TY, Song GW, Jung DH, Park GC, Lee SG (2018) Comparison of pure laparoscopic versus open left hemihepatectomy by multivariate analysis: a retrospective cohort study. Surg Endosc 32(2):643–650. https://doi.org/10.1007/s00464-017-5714-7

    Article  PubMed  Google Scholar 

  16. Yin X, Luo D, Huang Y, Huang M (2019) Advantages of laparoscopic left hemihepatectomy: a meta-analysis. Medicine (Baltimore) 98(23):e15929

    Article  Google Scholar 

  17. Dagher I, Di Giuro G, Dubrez J, Lainas P, Smadja C, Franco D (2009) Laparoscopic versus open right hepatectomy: a comparative study. Am J Surg 198(2):173–177

    Article  Google Scholar 

  18. Yu X, Luo D, Tang Y, Huang M, Huang Y (2019) Safety and feasibility of laparoscopy technology in right hemihepatectomy. Sci Rep 9:18809. https://doi.org/10.1038/s41598-019-52694-5

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Luo D, Xiong X, Xiong H, Liu H, Huang Y, Huang M (2020) The safety and feasibility of laparoscopic technology in right posterior sectionectomy. Surg Laparosc Endosc Percutan Tech 30(2):169–172. https://doi.org/10.1097/SLE.0000000000000772

    Article  PubMed  Google Scholar 

  20. Dagher I, Caillard C, Proske JM, Carloni A, Lainas P, Franco D (2008) Laparoscopic right hepatectomy: original technique and results. J Am Coll Surg 206(4):756–760. https://doi.org/10.1016/j.jamcollsurg.2007.09.012

    Article  PubMed  Google Scholar 

  21. Siddiqi NN, Abuawwad M, Halls M, Rawashdeh A, Giovinazzo F, Aljaiuossi A, Wicherts D, D'Hondt M, Hilal MA (2018) Laparoscopic right posterior sectionectomy (LRPS): surgical techniques and clinical outcomes. Surg Endosc 32(5):2525–2532. https://doi.org/10.1007/s00464-017-5958-2

    Article  PubMed  Google Scholar 

  22. Chaib E, Ribeiro MA Jr, Silva Fde S, Saad WA, Cecconello I (2007) Surgical approach for hepatic caudate lobectomy: review of 401 cases. J Am Coll Surg 204(1):118–127. https://doi.org/10.1016/j.jamcollsurg.2006.09.020

    Article  PubMed  Google Scholar 

  23. Oh D, Kwon CH, Na BG, Lee KW, Cho WT, Lee SH et al (2016) Surgical techniques for totally laparoscopic caudate lobectomy. J Laparoendosc Adv Surg Tech A 26(9):689–692. https://doi.org/10.1089/lap.2016.0161

    Article  PubMed  Google Scholar 

  24. Ho KM, Han HS, Yoon YS, Cho JY, Choi YR, Jang JS, Kwon SU, Kim S, Choi JK (2017) Laparoscopic total caudate lobectomy for hepatocellular carcinoma. J Laparoendosc Adv Surg Tech A 27(10):1074–1078. https://doi.org/10.1089/lap.2016.0459

    Article  PubMed  Google Scholar 

  25. Lei P, Liu X, Liu S, Lv Y (2012) Ex situ liver resection for unresectable tumors. J Dig Surg 29(2):140–148. https://doi.org/10.1159/000337305

    Article  Google Scholar 

  26. Xu G, Tong JX, Ji JJ, Wang H, Wu X’, Jin B, Xu H, Lu X, Sang X, Mao Y, du S, Hong Z (2020) Laparoscopic caudate lobectomy: a multicenter, propensity score-matched report of safety, feasibility, and early outcomes. Surg Endosc. https://doi.org/10.1007/s00464-020-07478-8

  27. Cappelle M, Aghayan DL, van der Poel MJ et al (2020) A multicenter cohort analysis of laparoscopic hepatic caudate lobe resection. Langenbeck's Arch Surg 405:181–189. https://doi.org/10.1007/s00423-020-01867-2

    Article  CAS  Google Scholar 

  28. Dongkyu O, Kwon CHD, Na BG et al (2016) Surgical techniques for totally laparoscopic caudate lobectomy. J Laparoendosc Adv Surg Tech A 26(9):689–692

    Article  Google Scholar 

  29. Dulucq JL, Wintringer P, Stabilini C, Mahajna A (2006) Isolated laparoscopic resection of the hepatic caudate lobe: surgical technique and a report of 2 cases. Surg Laparosc Endosc Percutan Tech 16:32–35

    Article  Google Scholar 

  30. Cheung TT (2016) Technical notes on pure laparoscopic isolated caudate lobectomy for patient with liver cancer. Transl Gastroenterol Hepatol 1:56. https://doi.org/10.21037/tgh.2016.06.06

    Article  PubMed  PubMed Central  Google Scholar 

  31. Li Y, Zeng KN, Ruan DY, Yao J, Yang Y, Chen GH, Wang GS (2019) Feasibility of laparoscopic isolated caudate lobe resection for rare hepatic mesenchymal neoplasms. World J Clin Cases 7(20):3194–3201

    Article  Google Scholar 

  32. Jin Y, Wang L, Yu YQ, Zhou DE, Liu DR, Yang JJ, Peng SY, Li JT (2017) Anatomic isolated caudate lobectomy: is it possible to establish a standard surgical flow? World J Gastroenterol 23(41):7433–7439

    Article  Google Scholar 

  33. Morino M, Morra I, Rosso E, Miglietta C, Garrone C (2003) Laparoscopic vs open hepatic resection: a comparative study. Surg Endosc 17(2):1914–1918. https://doi.org/10.1007/s00464-003-9070-4

    Article  CAS  PubMed  Google Scholar 

  34. Morise Z, Kawabe N, Kawase J, Tomishige H, Nagata H, Ohshima H, Arakawa S, Yoshida R, Isetani M (2013) Pure laparoscopic hepatectomy for hepatocellular carcinoma with chronic liver disease. World J Hepatol 5(9):487–495

    Article  Google Scholar 

  35. Soubrane O, Schwarz L, Cauchy F, Perotto LO, Brustia R, Bernard D, Scatton O (2015) A conceptual technique for laparoscopic right hepatectomy based on facts and oncologic principles: the caudal approach. Ann Surg 261:1226–1231. https://doi.org/10.1097/sla.0000000000000737

    Article  PubMed  Google Scholar 

  36. Ogiso S, Nomi T, Araki K et al (2015) Laparoscopy-specific surgical concepts for hepatectomy based on the laparoscopic caudal view: a key to reboot surgeons’ minds. Ann Surg Oncol 22(Suppl 3):S327–S333

    Article  Google Scholar 

  37. Di Fabio F, Samim M, Di Gioia P, Godeseth R, Pearce NW, Abu Hilal M (2014) Laparoscopic major hepatectomies: clinical outcomes and classification. World J Surg 38(12):3169–3174

    Article  Google Scholar 

  38. Koffron AJ, Auffenberg G, Kung R, Abecassis M (2007) Evaluation of 300 minimally invasive liver resections at a single institution: less is more. Ann Surg 246(3):385–394

    Article  Google Scholar 

  39. Polignano FM, Quyn AJ, de Figueiredo RS, Henderson NA, Kulli C, Tait IS (2008) Laparoscopic versus open liver segmentectomy: prospective, case-matched, intention-to-treat analysis of clinical outcomes and cost effectiveness. Surg Endosc 22(12):2564–2570. https://doi.org/10.1007/s00464-008-0110-y

    Article  PubMed  Google Scholar 

  40. Schemmer P, Friess H, Dervenis C, Schmidt J, Weitz J, Uhl W, Büchler MW (2007) The use of endo-GIA vascular staplers in liver surgery and their potential benefit: a review. Dig Surg 24(4):300–305. https://doi.org/10.1159/000103662

    Article  PubMed  Google Scholar 

  41. Kaneko H, Otsuka Y, Tsuchiya M, Tamura A, Katagiri T, Yamazaki K (2008) Application of devices for safe laparoscopic hepatectomy. HPB (Oxford) 10(4):219–224. https://doi.org/10.1080/13651820802166831

    Article  CAS  Google Scholar 

  42. Chang S, Laurent A, Tayar C, Karoui M, Cherqui D (2007) Laparoscopy as a routine approach for left lateral sectionectomy. Br J Surg 94(1):58–63. https://doi.org/10.1002/bjs.5562

    Article  CAS  PubMed  Google Scholar 

  43. Simillis C, Constantinides VA, Tekkis PP, Darzi A, Lovegrove R, Jiao L, Antoniou A (2007) Laparoscopic versus open hepatic resections for benign and malignant neoplasms--a meta-analysis. Surgery 141(2):203–211. https://doi.org/10.1016/j.surg.2006.06.035

    Article  PubMed  Google Scholar 

  44. Uchiyama K, Ueno M, Ozawa S, Kiriyama S, Shigekawa Y, Yamaue H (2010) Combined use of contrast-enhanced intraoperative ultrasonography and a fluorescence navigation system for identifying hepatic metastases. World J Surg 34(12):2953–2959. https://doi.org/10.1007/s00268-010-0764-1

    Article  PubMed  Google Scholar 

  45. Mizumoto R, Suzuki H (1988) Surgical anatomy of the hepatic hilum with special reference to the caudate lobe. World J Surg 12(1):2–10. https://doi.org/10.1007/bf01658479

    Article  CAS  PubMed  Google Scholar 

  46. Montorsi M, Santambrogio R, Bianchi P, Dapri G, Spinelli A, Podda M (2002) Perspectives and drawbacks of minimally invasive surgery for hepatocellular carcinoma. Hepatogastroenterology 49(43):56–61

    PubMed  Google Scholar 

  47. Inoue Y, Suzuki Y, Fujii K, Kawaguchi N, Ishii M, Masubuchi S, Yamamoto M, Hirokawa F, Hayashi M, Uchiyama K (2018) Laparoscopic hepatic resection using extracorporeal Pringle maneuver. J Laparoendosc Adv Surg Tech A 28(4):452–458. https://doi.org/10.1089/lap.2017.0196

    Article  PubMed  Google Scholar 

  48. Wei X, Zheng W, Yang Z, Liu H, Tang T, Li X, Liu X (2019) Effect of the intermittent Pringle maneuver on liver damage after hepatectomy: a retrospective cohort study. World J Surg Oncol 17(1):142. https://doi.org/10.1186/s12957-019-1680-y

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgments

This work was supported by National Natural Science Foundation of China (No. 81760514).

Author information

Author notes

  1. Zigang Ding and Yong Huang contributed equally to this work.

Authors and Affiliations

  1. Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China

    Zigang Ding, Yong Huang, Lingpeng Liu, Bangran Xu, Hu Xiong, Dilai Luo & Mingwen Huang

Authors
  1. Zigang Ding
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yong Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lingpeng Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bangran Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hu Xiong
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Dilai Luo
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Mingwen Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Study conception and design: Mingwen Huang, Yong Huang, Zigang Ding. Acquisition of data: Zigang Ding, Lingpeng Liu, Bangran Xu, Dilai Luo, Hu Xiong. Analysis and interpretation of data: Zigang Ding, Lingpeng Liu. Drafting of manuscript: Zigang Ding. Critical revision of manuscript: Yong Huang, Mingwen Huang.

Corresponding author

Correspondence to Mingwen Huang.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

The study was approved by the Second Affiliated Hospital of Nanchang University Ethics Committee, and specimens were taken with the patient’s full consent. This study was carried out in accordance with our institutional ethical guidelines and with the 1964 Helsinki declaration and its later amendments and regarding the involvement of human subjects and the use of human tissues for research.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ding, Z., Huang, Y., Liu, L. et al. Comparative analysis of the safety and feasibility of laparoscopic versus open caudate lobe resection. Langenbecks Arch Surg 405, 737–744 (2020). https://doi.org/10.1007/s00423-020-01928-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00423-020-01928-6

Keywords

Search

Navigation