Outcomes of Laparoscopic vs open Liver Resection for Hepatocellular Carcinoma-60 Cases

Background: Laparoscopic liver resection (LLR) has emerged as an alternative to open liver resection (OLR) for hepatocellular carcinoma (HCC), with potential advantages in reduced blood loss, shorter hospital stay, and faster recovery. However, comparative data from single-center series remain valuable for surgical decision-making.

Objective: To compare perioperative and oncologic outcomes of laparoscopic versus open liver resection for HCC in a single-center cohort of 60 consecutive patients.

Methods: This prospective observational study included 60 patients who underwent curative-intent liver resection for HCC between July2024 and June2025. Patients were allocated to LLR (n = 28) or OLR (n = 32) based on tumor location, surgeon judgment, and patient factors. Primary endpoints were perioperative outcomes (operative time, estimated blood loss, transfusion rate, complications, length of stay) and short-term oncologic outcomes (margin status, 90-day mortality). Secondary endpoints included 1-year recurrence-free survival (RFS) and overall survival (OS).

Results: Baseline characteristics including age, sex distribution, Child–Pugh class, and tumor size were similar between groups. LLR was associated with significantly lower median estimated blood loss (200 mL vs 450 mL, p = 0.003), lower transfusion rate (7% vs 28%, p = 0.04), and shorter median hospital stay (4 days vs 8 days, p < 0.001). Operative time was longer for LLR (median 240 min vs 200 min, p = 0.02). Overall complication rate was lower in the LLR group (18% vs 41%, p = 0.047); rates of major complications (Clavien–Dindo III–V) did not differ significantly. Negative microscopic margins (R0) were achieved in 93%of LLR and 88% of OLR cases (p = 0.52). Ninety-day mortality was 0% for LLR and 3% for OLR (p = 0.31). One-year RFS and OS were comparable between groups.

Conclusions: In this single-center series of 60 patients, laparoscopic liver resection demonstrated favorable perioperative outcomes including less blood loss, lower transfusion rates, fewer overall complications, and shorter hospital stay while achieving comparable short-term oncologic results to open resection. LLR is a safe and effective approach for selected patients with HCC when performed by experienced teams.

Keywords: Hepatocellular Carcinoma, Laparoscopic Liver Resection, Open Liver Resection, Perioperative Outcomes, Oncologic Outcomes.