{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T08:46:51Z","timestamp":1784882811150,"version":"3.55.0"},"reference-count":28,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T00:00:00Z","timestamp":1618963200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T00:00:00Z","timestamp":1618963200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T00:00:00Z","timestamp":1618963200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Several studies have suggested that laparoscopic liver resection (LLR) is associated with fewer postoperative complications than open liver resection (OLR) for hepatocellular carcinoma (HCC). However, this issue remains controversial since the data may have been attributable to an imbalance in patients\u2019 background.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively analyzed 290 hepatectomies for HCC undertaken between 2011 and 2019. Liver resection difficulty was based on the 3 levels of the Institut Mutualiste Montsouris classification. Resection ratio was calculated using computed tomography volumetry. Patient characteristics were compared between the LLR and OLR groups. Propensity score matching (PSM) was adopted to adjust the imbalance between the cohorts, and the incidence of postoperative complications was compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The difficulty and resection ratio were significantly lower in LLR (<jats:italic>n<\/jats:italic>\u2009=\u2009112) than in OLR (<jats:italic>n<\/jats:italic>\u2009=\u2009178) (difficulty grade I\/II\/III: 84\/10\/18 vs. 43\/39\/96, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001; resection ratio: 11.4\u2009\u00b1\u200912.7 vs. 22.7\u2009\u00b1\u200917.2%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The incidence of postoperative complications (Clavien\u2013Dindo grade III or more) was lower in LLR (2.7% vs. 21.9%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), which was mainly attributable to fewer incidences of ascites and pleural effusion. PSM generated 68 well\u2010matched patients in each group. The lower incidence of postoperative complications in LLR was also maintained in the PSM cohort (2.9% vs. 16.2%, <jats:italic>p<\/jats:italic>\u2009=\u20090.017). On multivariate analysis, LLR was the independent predictor of postoperative complications (OR 0.184, 95% CI 0.051\u20130.672, <jats:italic>p<\/jats:italic>\u2009=\u20090.010).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The present study demonstrated that a laparoscopic approach reduces the incidence of postoperative complications in liver resection for HCC.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-021-06115-2","type":"journal-article","created":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T14:08:36Z","timestamp":1619014116000},"page":"2572-2580","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Laparoscopic Versus Open Liver Resection for Hepatocellular Carcinoma: A Case Controlled Study with Propensity Score Matching"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7689-3680","authenticated-orcid":false,"given":"Yusuke","family":"Uemoto","sequence":"first","affiliation":[{"name":"Division of Hepato Biliary Pancreatic Surgery and Transplantation, Department of Surgery Graduate School of Medicine 54 Kawaharacho Shogoin, Sakyo\u2010ku 606\u20108507 Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kojiro","family":"Taura","sequence":"additional","affiliation":[{"name":"Division of Hepato Biliary Pancreatic Surgery and Transplantation, Department of Surgery Graduate School of Medicine 54 Kawaharacho Shogoin, Sakyo\u2010ku 606\u20108507 Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Nishio","sequence":"additional","affiliation":[{"name":"Division of Hepato Biliary Pancreatic Surgery and Transplantation, Department of Surgery Graduate School of Medicine 54 Kawaharacho Shogoin, Sakyo\u2010ku 606\u20108507 Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Kimura","sequence":"additional","affiliation":[{"name":"Division of Hepato Biliary Pancreatic Surgery and Transplantation, Department of Surgery Graduate School of Medicine 54 Kawaharacho Shogoin, Sakyo\u2010ku 606\u20108507 Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nguyen Hai","family":"Nam","sequence":"additional","affiliation":[{"name":"Division of Hepato Biliary Pancreatic Surgery and Transplantation, Department of Surgery Graduate School of Medicine 54 Kawaharacho Shogoin, Sakyo\u2010ku 606\u20108507 Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Yoshino","sequence":"additional","affiliation":[{"name":"Division of Hepato Biliary Pancreatic Surgery and Transplantation, Department of Surgery Graduate School of Medicine 54 Kawaharacho Shogoin, Sakyo\u2010ku 606\u20108507 Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoaki","family":"Yoh","sequence":"additional","affiliation":[{"name":"Division of Hepato Biliary Pancreatic Surgery and Transplantation, Department of Surgery Graduate School of Medicine 54 Kawaharacho Shogoin, Sakyo\u2010ku 606\u20108507 Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukinori","family":"Koyama","sequence":"additional","affiliation":[{"name":"Division of Hepato Biliary Pancreatic Surgery and Transplantation, Department of Surgery Graduate School of Medicine 54 Kawaharacho Shogoin, Sakyo\u2010ku 606\u20108507 Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Ogiso","sequence":"additional","affiliation":[{"name":"Division of Hepato Biliary Pancreatic Surgery and Transplantation, Department of Surgery Graduate School of Medicine 54 Kawaharacho Shogoin, Sakyo\u2010ku 606\u20108507 Kyoto 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