Evolution of Laparoscopic Liver Resection: Improved Perioperative Outcomes in Challenging Cases

The study analyzed the evolution of laparoscopic liver resection (LLR) over the past two decades at a Korean referral center. The number of technically challenging LLR procedures increased significantly, but perioperative outcomes improved. The most recent period showed shorter operation time, lower blood loss, reduced transfusions, and shorter hospital stays. Technical major resections and underlying liver cirrhosis were associated with longer operation time, while tumor size, major surgeries, and cirrhosis were linked to higher blood loss. LLR indications have expanded to include more challenging procedures and frail patients.