MS O11 - HPB Laparoscopic vs open liver resections for hepatocellular cancer in a tertiary care hepatobiliary unit; outcomes of cases over 10 years

Abstract Background Despite its established role in liver resection surgery, minimally invasive surgery is still not a favoured option in cases of hepatocellular cancer (HCC) due to perceived risks of intra- and post-operative surgical morbidity and poorer oncological outcomes. This study aims to look at the outcomes of liver resections performed for HCC cases over ten years comparing laparoscopic and open cohorts. Method A retrospective study including all liver resections for HCC cases performed in our tertiary care hepatobiliary unit between 2013 and 2022 (10 years) was conducted. Data on demographics, underlying degree of liver cirrhosis, types of liver resection and post-operative outcomes, including recurrence rates and resections margins were collected and reported using descriptive statistics. Survival analysis was performed with compared between these two groups with log rank test in GraphPad prism 10. Results 200 liver resections performed for HCC were grouped into laparoscopic and open cohorts containing 147 and 53 patients respectively. 21 (40%) laparoscopic cases had background liver cirrhosis as compared to 24 (16%) in open cases. Major liver resection comprised 9% and 43% of all cases and one and five patients had Grade B/C PHLF in laparoscopic and open groups. All 8 (4%) cases with 90-day mortality were from the open group. Negative resection margins (68% vs 71%), local recurrence (51% vs 47%) and overall survival (75 months vs 67 months (p=0.29)) were similar in laparoscopic and open groups, respectively. Conclusion Post-operative and oncological outcomes of liver resections for HCC were comparable in laparoscopic and open groups. Laparoscopic liver resections could be safely performed in patients with background liver cirrhosis.