Lap hepatectomy has better short-term outcomes and similar long-term survival as open hepatectomy for high difficulty HCC

Propensity score analysis of 424 patients who underwent liver resection for high difficulty hepatocellular carcinoma compared laparoscopic (LLR) and open approaches. LLR had significantly fewer severe complications (3% vs. 10.8%) and shorter hospital stays (6 days vs. 8 days). Long-term outcomes, including tumor recurrence rate, 5-year overall survival rate, and 5-year recurrence-free survival rate, were comparable between LLR and open approaches. The surgical approach did not influence survival. LLR is a viable option with better short-term outcomes and similar long-term survival for selected patients with high difficulty hepatocellular carcinoma.