Hasil Jangka Pendek dan Jangka Panjang Reseksi Hepatobilier Invasif Minimal Versus Terbuka: Tinjauan Sistematis dan Meta Analisis

Rachmawaddah Yolanda; Benly Levi Andreas Sibarani

doi:10.55606/detector.v4i3.6759

Authors

Rachmawaddah Yolanda RSUD dr. M. Yunus, Bengkulu
Benly Levi Andreas Sibarani Puskesmas Kahakitang Kepulauan Sangihe

DOI:

https://doi.org/10.55606/detector.v4i3.6759

Keywords:

Disease-Free Survival, Hepatobiliary Resection, Laparoscopy, Long-Term Outcomes, Short-Term Outcomes

Abstract

Hepatobiliary resection remains the primary surgical option for managing both benign and malignant diseases of the liver and biliary tract. Although conventional open surgery has long been the standard approach, minimally invasive or laparoscopic techniques continue to evolve and are increasingly applied to complex cases. However, debate persists regarding their long-term efficacy and oncological safety compared to open surgery. This study aimed to comprehensively evaluate and compare the short- and long-term outcomes of both surgical approaches. Through a systematic review and meta-analysis of relevant studies, perioperative data including intraoperative blood loss, length of hospital stay, complication rates, as well as oncological outcomes such as overall survival and disease-free survival were synthesized. The analysis revealed that the laparoscopic approach offers significant advantages in short-term outcomes, including reduced blood loss, faster functional recovery, and lower postoperative complication rates. Regarding long-term outcomes, the efficacy and oncological safety of laparoscopic techniques proved comparable to open procedures. Consequently, minimally invasive hepatobiliary resection represents a safe and effective alternative that warrants consideration as a standard clinical management strategy in digestive surgery.

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References

Aliseda, D. et al. (2023). Annals of Surgical Oncology—meta-analisis terbaru pada ICC dengan hasil jangka panjang.

Aliseda, D. et al. (2023). Laparoscopic versus open resection for intrahepatic cholangiocarcinoma: A systematic review and meta-analysis. Annals of Surgical Oncology, 30(3), 1945–1958.

Buell, J. F. et al. (2009). The international position on laparoscopic liver surgery: The Louisville Statement, 2008. Annals of Surgery, 250(5), 825–830. https://doi.org/10.1097/SLA.0b013e3181b3b2d8

Cassese, G. et al. (2024). Laparoscopic liver resection for large (>10 cm) HCC: Outcomes and survival. Surgical Endoscopy, 38(2), 1842–1855. https://doi.org/10.1007/s00464-024-11091-4

Cipriani, F. et al. (2016). BJS—menunjukkan OS dan DFS setara antara laparoskopi dan open.

Cipriani, F. et al. (2016). Propensity score analysis of laparoscopic versus open liver resection for colorectal metastases. British Journal of Surgery, 103(11), 1504–1512. https://doi.org/10.1002/bjs.10211

Ciria, R. et al. (2016). Laparoscopic liver resection in the era of rapid development: Systematic review and meta-analysis. Journal of Hepatobiliary Pancreatic Sciences, 23(5), 345–358.

DerSimonian, R., & Laird, N. (1986). Meta-analysis in clinical trials. Controlled Clinical Trials, 7(3), 177–188. https://doi.org/10.1016/0197-2456(86)90046-2

Efanov, M. et al. (2021). Long-term outcomes of laparoscopic versus open parenchyma-sparing liver resection. Surgical Endoscopy, 35(12), 7052–7061.

Egger, M. et al. (1997). Bias in meta-analysis detected by a simple, graphical test. BMJ, 315(7109), 629–634. https://doi.org/10.1136/bmj.315.7109.629

Fichtinger, J. et al. (2024). Laparoscopic versus open hemihepatectomy for malignancy: The ORANGE II PLUS trial. Journal of Clinical Oncology, 42(1), 31–44.

Fretland, Å. A. et al. (2018). Annals of Surgery—RCT OSLO-COMET Trial, menunjukkan manfaat laparoskopi pada CRLM.

Fretland, Å. A. et al. (2018). Laparoscopic versus open resection for colorectal liver metastases: The OSLO-COMET randomized trial. Annals of Surgery, 267(2), 199–207. https://doi.org/10.1097/SLA.0000000000002353

Haney, C. M. et al. (2021). HPB (Oxford)—meta-analisis RCT, melaporkan penurunan komplikasi mayor pada laparoskopi.

Haney, C. M. et al. (2021). Laparoscopic versus open liver resection: A systematic review and meta-analysis of randomized controlled trials. HPB (Oxford), 23(8), 1180–1191. https://doi.org/10.1016/j.hpb.2021.03.006

Hasegawa, Y. et al. (2017). Comparison of laparoscopic and open liver resection for HCC: Japanese nationwide study. Annals of Surgery, 266(4), 794–802.

Hasegawa, Y. et al. (2017). Comparison of laparoscopic and open liver resection for hepatocellular carcinoma: Japanese nationwide survey. Annals of Surgery, 266(4), 794–802.

Higgins, J. P. T. et al. (2023). Cochrane Handbook for Systematic Reviews of Interventions (Version 7). Wiley-Blackwell.

Hobeika, C. et al. (2021). Open versus laparoscopic approach for intrahepatic cholangiocarcinoma: A nationwide propensity-matched analysis. British Journal of Surgery, 108(4), 439–447. https://doi.org/10.1093/bjs/znaa110

Li, J. et al. (2017). Meta-analysis of laparoscopic versus open surgery for hepatolithiasis. World Journal of Gastroenterology, 23(21), 3860–3871. https://doi.org/10.3748/wjg.v23.i43.7791

Page, M. J. et al. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71

Russolillo, N. et al. (2024). Short- and long-term outcomes of laparoscopic versus open liver resection in high-burden colorectal metastases. Surgical Endoscopy, 38(1), 1123–1133. https://doi.org/10.1007/s00464-024-10797-9

Russolillo, N. et al. (2024). Surgical Endoscopy—menunjukkan peningkatan kualitas hasil jangka panjang pada laparoskopi.

Stang, A. (2010). Critical evaluation of the Newcastle-Ottawa Scale for assessing the quality of nonrandomized studies. European Journal of Epidemiology, 25(9), 603–605. https://doi.org/10.1007/s10654-010-9491-z

Tian, Y. et al. (2016). Meta-analysis of laparoscopic versus open liver resection for colorectal liver metastases. Oncotarget, 7(49), 84544–84555. https://doi.org/10.18632/oncotarget.13026

Tian, Y. et al. (2016). Oncotarget—meta-analisis CRLM dengan perbaikan outcome perioperatif.

Troisi, R. I. et al. (2021). Laparoscopic versus open hepatectomy for HCC in Child-Pugh B cirrhosis. British Journal of Surgery, 108(3), 352–360.

Troisi, R. I. et al. (2021). Laparoscopic versus open hepatectomy for hepatocellular carcinoma in Child-Pugh B cirrhosis. British Journal of Surgery, 108(3), 352–360.

Wakabayashi, G. et al. (2015). Recommendations for laparoscopic liver resection: Morioka consensus. Annals of Surgery, 261(4), 619–629. https://doi.org/10.1097/SLA.0000000000001183

Wan, X. et al. (2014). Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Medical Research Methodology, 14, 135. https://doi.org/10.1186/1471-2288-14-135

Xiong, J. J. et al. (2012). Meta-analysis of laparoscopic versus open liver resection for hepatocellular carcinoma. World Journal of Gastroenterology, 18(45), 6657–6668. https://doi.org/10.3748/wjg.v18.i45.6657