Open Versus Laparoscopic Liver Resection

Looking Beyond the Immediate Postoperative Period

The number of liver resections performed in the United States in on the rise. The procedure, which removes part of the liver, is used in cases related to metastatic colorectal cancer and liver cancer due to hepatitis C. The median cost of hospitalization for liver resection surgery has more than doubled in the 10 years from 1997 to 2007—from $23,856 to $50,758.

These researchers compared morbidity for the procedure (in-house, 30-day readmission and one-year readmission) by surgical method. They collected data for 76 patients and compared 49 patients who received open resections with 27 patients who were operated on laparoscopically. Previous studies had focused only on outcomes during the hospital stay.

Patients undergoing laparoscopic surgery had significantly less blood loss and shorter hospital stays (five days) than those who had the open procedure (eight days). Related to the length of stay, more open-group patients experienced complications. At 30 days, readmission rates were not much different, but at one year they were significantly higher for the open surgery group.

While operating time and operating room costs are higher for the laparoscopic approach, those costs are more than recovered over time. That translates into lower costs for patients and health care systems.

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