Meta-Analysis
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World J Gastroenterol. Jul 7, 2014; 20(25): 8274-8281
Published online Jul 7, 2014. doi: 10.3748/wjg.v20.i25.8274
Laparoscopic vs open approach to resection of hepatocellular carcinoma in patients with known cirrhosis: Systematic review and meta-analysis
Ahmed Twaij, Philip H Pucher, Mikael H Sodergren, Tamara Gall, Ara Darzi, Long R Jiao
Ahmed Twaij, Philip H Pucher, Mikael H Sodergren, Ara Darzi, Department of Surgery and Cancer, QEQM Building, St Mary’s Hospital, Imperial College, London W2 1NY, United Kingdom
Tamara Gall, Long R Jiao, Department of Surgery, Hammersmith Hospital, Imperial College London, London SW7 2AZ, United Kingdom
Author contributions: Twaij A was involved with study design, data collection, data analysis, drafting of manuscript; Pucher PH contributed to study design, data collection, data analysis, drafting of manuscript; Sodergren MH performed study design, data analysis, and drafting of manuscript; Gall T, Darzi A and Jiao LR were involved with revision of the manuscript and final approval.
Correspondence to: Mikael H Sodergren, PhD, FRCS, Department of Surgery and Cancer, QEQM Building, St Mary’s Hospital, Imperial College, Praed Street, London W2 1NY, United Kingdom. m.sodergren@imperial.ac.uk
Telephone: +44-20-3312 6666 Fax: +44-20-33126309
Received: November 2, 2013
Revised: December 17, 2013
Accepted: March 19, 2014
Published online: July 7, 2014
Core Tip

Core tip: Laparoscopic surgery is now considered the gold standard for the majority of surgical procedures. Minimally invasive surgery in oncological cases has been shown to provide enhanced recovery and overall better outcomes compared to an open approach. Although slower to be implemented, laparoscopic hepatic surgery is now considered safe and, in many situations, better than an open technique. Cirrhotic livers have always been considered technically difficult to approach surgically. This review suggests that not only is laparoscopic surgery for patients with hepatocellular carcinoma and known known cirrhosis safe, it may have improved outcomes compared to the open technique.