Cut Surface Biliary Complications in Open and Laparoscopic Liver Resections - A Single Center Analysis
Author(s): Sebastian Recknagel, Uwe Scheuermann, Hanna Guice1, Elisabeth Sucher, Andri Lederer, Claudia Hohne, Daniel Seehofer, Robert Sucher, Sebastian Rademacher
Background/Aims: Biliary leakage (BL) is a major cause of postoperative morbidity after liver resection. Aim of our study was to analyse surgical parameters and postoperative morbidity with special emphasis on BL, after launching a minimally invasive liver resection program.
Methods: A prospectively maintained medical database of patients who required a liver resection was used for analysis.
Results: A total of n=156 patients were divided into a group of n=47 patients (30.1%) receiving laparoscopic (LLR) and n=109 patients (69.9%) undergoing open liver resections (OLR). Patient age (OLR: 59.4 ± 16.0 vs. LLR: 57.9 ± 14.2 years) and male to female ratio (OLR: 63/46 vs. LLR: 25/22) were comparable. We performed n=75 (68.8%) major OLR and n=31 (66.0%) major LLR. Operation time was OLR 342.8 ± 110.5 min vs. LLR 287.3 ± 132.6 min (p=0.014) and the average blood loss was OLR 523.5 ± 428.6 ml vs. LLR 355.5 ± 459.2 ml. Morbidity and mortality was observed in n= 29 (18.6 %) and n= 7 (4.5 %) patients, respectively. The overall biliary leakage (BL) rate was 5.1% (n= 8). Majority of BL were detected in OLR with biliodigestive anastomosis (BDA) (n=2 (11.0%)) followed by OLR without BDA (n=6 (6.5%)). No BL were detected in patients with LLR. Hospital stay was significantly prolonged after OLR in patients with BL (38.4 ± 20.1 vs. 17.4 ± 11.1 days, p< 0.001).
Conclusion: The introduction of different transection techniques in laparoscopic liver resections did not increase morbidity and BL- rate.