{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T07:25:44Z","timestamp":1786951544495,"version":"build-2736575974"},"reference-count":23,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2026,8]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Laparoscopic liver resection (LLR) for posterosuperior (PS) segments remains technically challenging. Prior meta\u2010analyses comparing LLR to open liver resection (OLR) often incorporated unmatched retrospective data, introducing severe selection bias, and predated recent randomized controlled trials (RCTs). This systematic review and meta\u2010analysis evaluates the safety, short\u2010term recovery, and oncological efficacy of LLR versus OLR specifically for parenchymal\u2010preserving liver resection in PS segments (Couinaud segments 1, 4a, 7, and 8).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A systematic literature search of PubMed, EMBase, Cochrane Library, and ClinicalTrials.gov was conducted through March 2026. Inclusion was strictly limited to RCTs and propensity score\u2010matched (PSM) retrospective cohorts comparing LLR and OLR for tumors in PS segments. Major hepatectomies were intentionally excluded. Evaluated outcomes included estimated blood loss (EBL), operative time, major complications (Clavien\u2010Dindo\u00a0\u2265\u00a0III), length of hospital stay (LOS), and R0 resection rate.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Sixteen studies (2 RCTs, 14 PSM cohorts) encompassing 2372 patients (LLR\u00a0=\u00a01125; OLR\u00a0=\u00a01247) were included. In the PSM cohort, LLR significantly reduced EBL (MD\u00a0=\u00a0\u2212161.07\u00a0mL;\n p<\/jats:italic>\n \u00a0<\u00a00.00001) and major complications (OR\u00a0=\u00a00.55;\n p<\/jats:italic>\n \u00a0=\u00a00.002), whereas RCTs showed no statistical difference but exhibited extreme heterogeneity. Both study designs confirmed LLR significantly shortened LOS (RCT: MD\u00a0=\u00a0\u22121.50\u00a0days,\n p<\/jats:italic>\n \u00a0=\u00a00.003; PSM: MD\u00a0=\u00a0\u22122.30\u00a0days,\n p<\/jats:italic>\n \u00a0<\u00a00.00001). For tumors isolated in segments 7 and 8, LLR required marginally longer operative time (MD\u00a0=\u00a032.59\u00a0min;\n p<\/jats:italic>\n \u00a0=\u00a00.09). Oncological radicality was identical between approaches in the PSM cohorts with zero statistical heterogeneity (\n I<\/jats:italic>\n 2<\/jats:sup>\n \u00a0=\u00a00%).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n LLR for parenchymal\u2010preserving resection of PS liver tumors offers a highly favorable risk\u2010to\u2010benefit profile. Despite a modest increase in operative time, LLR significantly reduces blood loss, lowers major complication rates, and accelerates hospital discharge without compromising R0 resection rates. This minimally invasive approach should be strongly considered as a safe alternative to OLR in specialized, high\u2010volume hepatobiliary centers performing over 30 to 50 of these procedures annually.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/wjs.70461","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T06:26:07Z","timestamp":1781245567000},"page":"2443-2454","source":"Crossref","is-referenced-by-count":0,"title":["Laparoscopic Versus Open Parenchymal\u2010Preserving Liver Resection for Tumors in the Posterosuperior Segments a Systematic Review and Meta\u2010Analysis of Randomized Controlled Trials and Propensity Score\u2010Matched Studies"],"prefix":"10.1002","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1987-6115","authenticated-orcid":false,"given":"Chin\u2010Hsin","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Surgery Yuan's General Hospital Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po\u2010Yu","family":"Yeh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Changhua Christian Hospital Changhua Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001413"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001184"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002524"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.11286"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hpb.2024.06.003"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/jrsm.1429"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102288\u201014\u2010135"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2025.101228"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hpb.2019.03.358"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010025\u201012337\u20105"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010023\u201010291\u20108"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/hepr.13929"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2023.1095357"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2023.1112380"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.17849"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010022\u201006468\u20102"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2021.09.021"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605\u2010022\u201005389\u20108"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010019\u201007363\u2010z"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hpb.2019.05.006"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010017\u20105861\u2010x"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10489"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010014\u20103687\u20103"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wjs.70461","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/wjs.70461","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wjs.70461","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T06:59:41Z","timestamp":1786949981000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/wjs.70461"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,11]]},"references-count":23,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/wjs.70461"],"URL":"https:\/\/doi.org\/10.1002\/wjs.70461","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,11]]}}}