Laparoscopic and open minor liver resection for hepatocellular carcinoma with clinically significant portal hypertension: a multicenter study using inverse probability weighting approach
Background Liver resection offers substantial advantages over open liver resection (OLR) for patients with hepatocellular carcinoma (HCC) in terms of reduced intraoperative blood loss and morbidity. However, there is limited evidence comparing the indications and perioperative outcomes with the open...
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| Veröffentlicht in: | Surgical endoscopy 2024-02, Vol.38 (2), p.757-768 |
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| creator | Shinkawa, Hiroji Kaibori, Masaki Kabata, Daijiro Nakai, Takuya Ueno, Masaki Hokuto, Daisuke Ikoma, Hisashi Iida, Hiroya Komeda, Koji Tanaka, Shogo Kosaka, Hisashi Nobori, Chihoko Hayami, Shinya Yasuda, Satoshi Morimura, Ryo Mori, Haruki Kagota, Shuji Kubo, Shoji Ishizawa, Takeaki |
| description | Background
Liver resection offers substantial advantages over open liver resection (OLR) for patients with hepatocellular carcinoma (HCC) in terms of reduced intraoperative blood loss and morbidity. However, there is limited evidence comparing the indications and perioperative outcomes with the open versus laparoscopic approach for resection. This study aimed to compare postoperative outcomes between patients undergoing laparoscopic liver resection (LLR) and OLR for HCC with clinically significant portal hypertension (CSPH).
Methods
A total of 316 HCC patients with CSPH (the presence of gastroesophageal varices or platelet count 12 cm) undergoing minor liver resection at eight centers were included in this study. To adjust for confounding factors between the LLR and OLR groups, an inverse probability weighting method analysis was performed.
Results
Overall, 193 patients underwent LLR and 123 underwent OLR. After weighting, LLR was associated with a lower volume of intraoperative blood loss and the incidence of postoperative complications (including pulmonary complications, incisional surgical site infection, and paralytic ileus) compared to the OLR group. The 3-, 5-, and 7-year postoperative recurrence-free survival rates were 39%, 26%, and 22% in the LLR group and 49%, 18%, and 18% in the OLR group, respectively (
p
= 0.18). And, the 3-, 5-, and 7-year postoperative overall survival rates were 71%, 56%, and 44% in the LLR group and 76%, 51%, 44% in the OLR group, respectively (
p
= 0.87).
Conclusions
LLR for HCC patients with CSPH is clinically advantageous by lowering the volume of intraoperative blood loss and incidence of postoperative complications, thereby offering feasible long-term survival.
Graphical abstract |
| doi_str_mv | 10.1007/s00464-023-10591-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2898957336</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2921192713</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-a2c6056479fc0753c995f889694a7b848f36e3816d31f5735a57ce3e8f8c25e13</originalsourceid><addsrcrecordid>eNp9kc1u1DAUhS0EokPLC7BAltiwCfgnTmx2qCo_0khs6NryeG4mrhw72A5V-mg8XT1MAYlFV5bv_e45V_cg9IqSd5SQ_n0mpO3ahjDeUCIUbe6eoA1tOWsYo_Ip2hDFScN61Z6hFznfkMorKp6jMy6JYFL2G_Rra2aTYrZxdhabsMdxhoAnF2LC3v2EhBNksMXFgIdaG2E2JVrwfvEmYWuSrexk8K0rI7beBWeN9yvO7hDcUD-h4DmmYjwe1xlSgZCr2Ads8LT44iyEUl1yWfYrXrILB-xC9c2A5xR3Zue8Kyu-BXcYy7Fr5lo3drxAzwbjM7x8eM_R9aer75dfmu23z18vP24by1lXGsNsR0TX9mqwpBfcKiUGKVWnWtPvZCsH3gGXtNtzOoieCyN6CxzkIC0TQPk5envSrbY_FshFTy4fD2ACxCVrJpVUdZB3FX3zH3oTlxTqdpopRqliPeWVYifK1sPnBIOek5tMWjUl-pisPiWra7L6d7L6rg69fpBedhPs_478ibIC_ATk2goHSP-8H5G9B9sbtHE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2921192713</pqid></control><display><type>article</type><title>Laparoscopic and open minor liver resection for hepatocellular carcinoma with clinically significant portal hypertension: a multicenter study using inverse probability weighting approach</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Shinkawa, Hiroji ; Kaibori, Masaki ; Kabata, Daijiro ; Nakai, Takuya ; Ueno, Masaki ; Hokuto, Daisuke ; Ikoma, Hisashi ; Iida, Hiroya ; Komeda, Koji ; Tanaka, Shogo ; Kosaka, Hisashi ; Nobori, Chihoko ; Hayami, Shinya ; Yasuda, Satoshi ; Morimura, Ryo ; Mori, Haruki ; Kagota, Shuji ; Kubo, Shoji ; Ishizawa, Takeaki</creator><creatorcontrib>Shinkawa, Hiroji ; Kaibori, Masaki ; Kabata, Daijiro ; Nakai, Takuya ; Ueno, Masaki ; Hokuto, Daisuke ; Ikoma, Hisashi ; Iida, Hiroya ; Komeda, Koji ; Tanaka, Shogo ; Kosaka, Hisashi ; Nobori, Chihoko ; Hayami, Shinya ; Yasuda, Satoshi ; Morimura, Ryo ; Mori, Haruki ; Kagota, Shuji ; Kubo, Shoji ; Ishizawa, Takeaki</creatorcontrib><description>Background
Liver resection offers substantial advantages over open liver resection (OLR) for patients with hepatocellular carcinoma (HCC) in terms of reduced intraoperative blood loss and morbidity. However, there is limited evidence comparing the indications and perioperative outcomes with the open versus laparoscopic approach for resection. This study aimed to compare postoperative outcomes between patients undergoing laparoscopic liver resection (LLR) and OLR for HCC with clinically significant portal hypertension (CSPH).
Methods
A total of 316 HCC patients with CSPH (the presence of gastroesophageal varices or platelet count < 100,000/ml and spleen diameter > 12 cm) undergoing minor liver resection at eight centers were included in this study. To adjust for confounding factors between the LLR and OLR groups, an inverse probability weighting method analysis was performed.
Results
Overall, 193 patients underwent LLR and 123 underwent OLR. After weighting, LLR was associated with a lower volume of intraoperative blood loss and the incidence of postoperative complications (including pulmonary complications, incisional surgical site infection, and paralytic ileus) compared to the OLR group. The 3-, 5-, and 7-year postoperative recurrence-free survival rates were 39%, 26%, and 22% in the LLR group and 49%, 18%, and 18% in the OLR group, respectively (
p
= 0.18). And, the 3-, 5-, and 7-year postoperative overall survival rates were 71%, 56%, and 44% in the LLR group and 76%, 51%, 44% in the OLR group, respectively (
p
= 0.87).
Conclusions
LLR for HCC patients with CSPH is clinically advantageous by lowering the volume of intraoperative blood loss and incidence of postoperative complications, thereby offering feasible long-term survival.
Graphical abstract</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-023-10591-z</identifier><identifier>PMID: 38052887</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Blood Loss, Surgical ; Carcinoma, Hepatocellular - complications ; Carcinoma, Hepatocellular - surgery ; Clinical significance ; Gastroenterology ; Gynecology ; Hepatectomy - methods ; Hepatology ; Humans ; Hypertension ; Hypertension, Portal - complications ; Hypertension, Portal - surgery ; Laparoscopy ; Laparoscopy - methods ; Length of Stay ; Liver cancer ; Liver Neoplasms - complications ; Liver Neoplasms - surgery ; Medicine ; Medicine & Public Health ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Postoperative Complications - surgery ; Proctology ; Propensity Score ; Retrospective Studies ; Surgery ; Surgical outcomes ; Surgical techniques ; Surgical Wound Infection - etiology</subject><ispartof>Surgical endoscopy, 2024-02, Vol.38 (2), p.757-768</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-a2c6056479fc0753c995f889694a7b848f36e3816d31f5735a57ce3e8f8c25e13</cites><orcidid>0000-0002-0164-2414</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-023-10591-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-023-10591-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,777,781,27906,27907,41470,42539,51301</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38052887$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shinkawa, Hiroji</creatorcontrib><creatorcontrib>Kaibori, Masaki</creatorcontrib><creatorcontrib>Kabata, Daijiro</creatorcontrib><creatorcontrib>Nakai, Takuya</creatorcontrib><creatorcontrib>Ueno, Masaki</creatorcontrib><creatorcontrib>Hokuto, Daisuke</creatorcontrib><creatorcontrib>Ikoma, Hisashi</creatorcontrib><creatorcontrib>Iida, Hiroya</creatorcontrib><creatorcontrib>Komeda, Koji</creatorcontrib><creatorcontrib>Tanaka, Shogo</creatorcontrib><creatorcontrib>Kosaka, Hisashi</creatorcontrib><creatorcontrib>Nobori, Chihoko</creatorcontrib><creatorcontrib>Hayami, Shinya</creatorcontrib><creatorcontrib>Yasuda, Satoshi</creatorcontrib><creatorcontrib>Morimura, Ryo</creatorcontrib><creatorcontrib>Mori, Haruki</creatorcontrib><creatorcontrib>Kagota, Shuji</creatorcontrib><creatorcontrib>Kubo, Shoji</creatorcontrib><creatorcontrib>Ishizawa, Takeaki</creatorcontrib><title>Laparoscopic and open minor liver resection for hepatocellular carcinoma with clinically significant portal hypertension: a multicenter study using inverse probability weighting approach</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
Liver resection offers substantial advantages over open liver resection (OLR) for patients with hepatocellular carcinoma (HCC) in terms of reduced intraoperative blood loss and morbidity. However, there is limited evidence comparing the indications and perioperative outcomes with the open versus laparoscopic approach for resection. This study aimed to compare postoperative outcomes between patients undergoing laparoscopic liver resection (LLR) and OLR for HCC with clinically significant portal hypertension (CSPH).
Methods
A total of 316 HCC patients with CSPH (the presence of gastroesophageal varices or platelet count < 100,000/ml and spleen diameter > 12 cm) undergoing minor liver resection at eight centers were included in this study. To adjust for confounding factors between the LLR and OLR groups, an inverse probability weighting method analysis was performed.
Results
Overall, 193 patients underwent LLR and 123 underwent OLR. After weighting, LLR was associated with a lower volume of intraoperative blood loss and the incidence of postoperative complications (including pulmonary complications, incisional surgical site infection, and paralytic ileus) compared to the OLR group. The 3-, 5-, and 7-year postoperative recurrence-free survival rates were 39%, 26%, and 22% in the LLR group and 49%, 18%, and 18% in the OLR group, respectively (
p
= 0.18). And, the 3-, 5-, and 7-year postoperative overall survival rates were 71%, 56%, and 44% in the LLR group and 76%, 51%, 44% in the OLR group, respectively (
p
= 0.87).
Conclusions
LLR for HCC patients with CSPH is clinically advantageous by lowering the volume of intraoperative blood loss and incidence of postoperative complications, thereby offering feasible long-term survival.
Graphical abstract</description><subject>Abdominal Surgery</subject><subject>Blood Loss, Surgical</subject><subject>Carcinoma, Hepatocellular - complications</subject><subject>Carcinoma, Hepatocellular - surgery</subject><subject>Clinical significance</subject><subject>Gastroenterology</subject><subject>Gynecology</subject><subject>Hepatectomy - methods</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension, Portal - complications</subject><subject>Hypertension, Portal - surgery</subject><subject>Laparoscopy</subject><subject>Laparoscopy - methods</subject><subject>Length of Stay</subject><subject>Liver cancer</subject><subject>Liver Neoplasms - complications</subject><subject>Liver Neoplasms - surgery</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - surgery</subject><subject>Proctology</subject><subject>Propensity Score</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Surgical techniques</subject><subject>Surgical Wound Infection - etiology</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1u1DAUhS0EokPLC7BAltiwCfgnTmx2qCo_0khs6NryeG4mrhw72A5V-mg8XT1MAYlFV5bv_e45V_cg9IqSd5SQ_n0mpO3ahjDeUCIUbe6eoA1tOWsYo_Ip2hDFScN61Z6hFznfkMorKp6jMy6JYFL2G_Rra2aTYrZxdhabsMdxhoAnF2LC3v2EhBNksMXFgIdaG2E2JVrwfvEmYWuSrexk8K0rI7beBWeN9yvO7hDcUD-h4DmmYjwe1xlSgZCr2Ads8LT44iyEUl1yWfYrXrILB-xC9c2A5xR3Zue8Kyu-BXcYy7Fr5lo3drxAzwbjM7x8eM_R9aer75dfmu23z18vP24by1lXGsNsR0TX9mqwpBfcKiUGKVWnWtPvZCsH3gGXtNtzOoieCyN6CxzkIC0TQPk5envSrbY_FshFTy4fD2ACxCVrJpVUdZB3FX3zH3oTlxTqdpopRqliPeWVYifK1sPnBIOek5tMWjUl-pisPiWra7L6d7L6rg69fpBedhPs_478ibIC_ATk2goHSP-8H5G9B9sbtHE</recordid><startdate>20240201</startdate><enddate>20240201</enddate><creator>Shinkawa, Hiroji</creator><creator>Kaibori, Masaki</creator><creator>Kabata, Daijiro</creator><creator>Nakai, Takuya</creator><creator>Ueno, Masaki</creator><creator>Hokuto, Daisuke</creator><creator>Ikoma, Hisashi</creator><creator>Iida, Hiroya</creator><creator>Komeda, Koji</creator><creator>Tanaka, Shogo</creator><creator>Kosaka, Hisashi</creator><creator>Nobori, Chihoko</creator><creator>Hayami, Shinya</creator><creator>Yasuda, Satoshi</creator><creator>Morimura, Ryo</creator><creator>Mori, Haruki</creator><creator>Kagota, Shuji</creator><creator>Kubo, Shoji</creator><creator>Ishizawa, Takeaki</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0164-2414</orcidid></search><sort><creationdate>20240201</creationdate><title>Laparoscopic and open minor liver resection for hepatocellular carcinoma with clinically significant portal hypertension: a multicenter study using inverse probability weighting approach</title><author>Shinkawa, Hiroji ; Kaibori, Masaki ; Kabata, Daijiro ; Nakai, Takuya ; Ueno, Masaki ; Hokuto, Daisuke ; Ikoma, Hisashi ; Iida, Hiroya ; Komeda, Koji ; Tanaka, Shogo ; Kosaka, Hisashi ; Nobori, Chihoko ; Hayami, Shinya ; Yasuda, Satoshi ; Morimura, Ryo ; Mori, Haruki ; Kagota, Shuji ; Kubo, Shoji ; Ishizawa, Takeaki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-a2c6056479fc0753c995f889694a7b848f36e3816d31f5735a57ce3e8f8c25e13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Abdominal Surgery</topic><topic>Blood Loss, Surgical</topic><topic>Carcinoma, Hepatocellular - complications</topic><topic>Carcinoma, Hepatocellular - surgery</topic><topic>Clinical significance</topic><topic>Gastroenterology</topic><topic>Gynecology</topic><topic>Hepatectomy - methods</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension, Portal - complications</topic><topic>Hypertension, Portal - surgery</topic><topic>Laparoscopy</topic><topic>Laparoscopy - methods</topic><topic>Length of Stay</topic><topic>Liver cancer</topic><topic>Liver Neoplasms - complications</topic><topic>Liver Neoplasms - surgery</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - surgery</topic><topic>Proctology</topic><topic>Propensity Score</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Surgical techniques</topic><topic>Surgical Wound Infection - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shinkawa, Hiroji</creatorcontrib><creatorcontrib>Kaibori, Masaki</creatorcontrib><creatorcontrib>Kabata, Daijiro</creatorcontrib><creatorcontrib>Nakai, Takuya</creatorcontrib><creatorcontrib>Ueno, Masaki</creatorcontrib><creatorcontrib>Hokuto, Daisuke</creatorcontrib><creatorcontrib>Ikoma, Hisashi</creatorcontrib><creatorcontrib>Iida, Hiroya</creatorcontrib><creatorcontrib>Komeda, Koji</creatorcontrib><creatorcontrib>Tanaka, Shogo</creatorcontrib><creatorcontrib>Kosaka, Hisashi</creatorcontrib><creatorcontrib>Nobori, Chihoko</creatorcontrib><creatorcontrib>Hayami, Shinya</creatorcontrib><creatorcontrib>Yasuda, Satoshi</creatorcontrib><creatorcontrib>Morimura, Ryo</creatorcontrib><creatorcontrib>Mori, Haruki</creatorcontrib><creatorcontrib>Kagota, Shuji</creatorcontrib><creatorcontrib>Kubo, Shoji</creatorcontrib><creatorcontrib>Ishizawa, Takeaki</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shinkawa, Hiroji</au><au>Kaibori, Masaki</au><au>Kabata, Daijiro</au><au>Nakai, Takuya</au><au>Ueno, Masaki</au><au>Hokuto, Daisuke</au><au>Ikoma, Hisashi</au><au>Iida, Hiroya</au><au>Komeda, Koji</au><au>Tanaka, Shogo</au><au>Kosaka, Hisashi</au><au>Nobori, Chihoko</au><au>Hayami, Shinya</au><au>Yasuda, Satoshi</au><au>Morimura, Ryo</au><au>Mori, Haruki</au><au>Kagota, Shuji</au><au>Kubo, Shoji</au><au>Ishizawa, Takeaki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Laparoscopic and open minor liver resection for hepatocellular carcinoma with clinically significant portal hypertension: a multicenter study using inverse probability weighting approach</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2024-02-01</date><risdate>2024</risdate><volume>38</volume><issue>2</issue><spage>757</spage><epage>768</epage><pages>757-768</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Background
Liver resection offers substantial advantages over open liver resection (OLR) for patients with hepatocellular carcinoma (HCC) in terms of reduced intraoperative blood loss and morbidity. However, there is limited evidence comparing the indications and perioperative outcomes with the open versus laparoscopic approach for resection. This study aimed to compare postoperative outcomes between patients undergoing laparoscopic liver resection (LLR) and OLR for HCC with clinically significant portal hypertension (CSPH).
Methods
A total of 316 HCC patients with CSPH (the presence of gastroesophageal varices or platelet count < 100,000/ml and spleen diameter > 12 cm) undergoing minor liver resection at eight centers were included in this study. To adjust for confounding factors between the LLR and OLR groups, an inverse probability weighting method analysis was performed.
Results
Overall, 193 patients underwent LLR and 123 underwent OLR. After weighting, LLR was associated with a lower volume of intraoperative blood loss and the incidence of postoperative complications (including pulmonary complications, incisional surgical site infection, and paralytic ileus) compared to the OLR group. The 3-, 5-, and 7-year postoperative recurrence-free survival rates were 39%, 26%, and 22% in the LLR group and 49%, 18%, and 18% in the OLR group, respectively (
p
= 0.18). And, the 3-, 5-, and 7-year postoperative overall survival rates were 71%, 56%, and 44% in the LLR group and 76%, 51%, 44% in the OLR group, respectively (
p
= 0.87).
Conclusions
LLR for HCC patients with CSPH is clinically advantageous by lowering the volume of intraoperative blood loss and incidence of postoperative complications, thereby offering feasible long-term survival.
Graphical abstract</abstract><cop>New York</cop><pub>Springer US</pub><pmid>38052887</pmid><doi>10.1007/s00464-023-10591-z</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-0164-2414</orcidid></addata></record> |
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| subjects | Abdominal Surgery Blood Loss, Surgical Carcinoma, Hepatocellular - complications Carcinoma, Hepatocellular - surgery Clinical significance Gastroenterology Gynecology Hepatectomy - methods Hepatology Humans Hypertension Hypertension, Portal - complications Hypertension, Portal - surgery Laparoscopy Laparoscopy - methods Length of Stay Liver cancer Liver Neoplasms - complications Liver Neoplasms - surgery Medicine Medicine & Public Health Postoperative Complications - epidemiology Postoperative Complications - etiology Postoperative Complications - surgery Proctology Propensity Score Retrospective Studies Surgery Surgical outcomes Surgical techniques Surgical Wound Infection - etiology |
| title | Laparoscopic and open minor liver resection for hepatocellular carcinoma with clinically significant portal hypertension: a multicenter study using inverse probability weighting approach |
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