• Daisuke Ban, Minoru Tanabe, Hiraku Kumamaru, Hiroyuki Nitta, Yuichiro Otsuka, Hiroaki Miyata, Yoshihiro Kakeji, Yuko Kitagawa, Hironori Kaneko, Go Wakabayashi, Hiroki Yamaue, and Masakazu Yamamoto.
• Japanese Society of Hepato-Biliary-Pancreatic Surgery, Tokyo, Japan.
• Ann. Surg. 2021 Dec 1; 274 (6): 104310501043-1050.

ObjectiveTo investigate the frequency of laparoscopic liver resection (LLR) nationwide in Japan.BackgroundLLR was initially limited to basic liver resection, but is becoming more common in advanced liver resection.MethodsRetrospective observational study of 148,507 patients registered in the National Clinical Database 2011-2017. Excluded: liver resection with biliary and vascular reconstruction.ResultsLLR or open liver resection (OLR) was performed in 1848 (9.9%) and 16,888 (90.1%) patients, respectively, in 2011, whereas in 2017, LLR had increased to 24.8% and OLR decreased to 75.2% of resections (5648 and 17,099 patients, respectively). There was an annual increasing trend of LLR, starting at 9.9%, then 13.8%, 17.3%, 21.2%, 18.1%, 21.0%, and finally 24.8% in 2017. Basic LLR became more common, up to 30.8% of LR in 2017. Advanced LLR increased from 3.3% of all resections in 2011 to 10.8% in 2017. Throughout the years observed, there were fewer complications in LLR than OLR. Operative mortality was 3.6% for both advanced LLR and OLR in 2011, and decreased to 1.0% and 2.0%, respectively, in 2017. Mortality for both basic LLR and basic OLR were low and did not change throughout the study, at 0.5% and 1.6%, respectively, in 2011 and 0.5% and 1.1%, in 2017.ConclusionsLLR has rapidly become widespread in Japan. Basic LLR is now a standard option, and advanced LLR, while not as common yet, has been increasing year by year. LLR has been safely developed with low mortality and complications rate relative to OLR.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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