HPB O04 Venous thromboembolism after hepatectomy: comparison between open and minimally invasive liver resection. Results of a systematic review with meta-analysis

Abstract Background Even though the risk of postoperative venous thromboembolism (VTE) after liver resection is well recognized, the association between surgical approach and VTE risk is unknown. This study aims to compare VTE rates following open liver resection (OLR) and minimally invasive liver resection (MILR). Methods MEDLINE, Web Of Sciences and EMBASE databases were analyzed to identify eligible studies. The studies that we included in the meta-analysis were published between February 2016 and May 2021. The last database search was performed on May 22nd, 2022. Studies were considered suitable if they reported a comparison between OLR and MILR (including laparoscopic liver resection [LLR] or robotic liver resection, [RLR]), or if postoperative VTE was the main focus of the study. Extracted data were pooled and subsequently used in a meta-analysis. Results 14 studies including 11356 patients met inclusion criteria and were considered for meta-analysis, with a total of 5622 patients who underwent OLR and 5734 patients who underwent MILR. Overall, our findings showed that VTE rate was higher among patients who underwent OLR compared to MILR (2.8% vs 1.4%, p=<00001). Similarly, the subgroup analysis showed a higher rate of deep venous thrombosis (DVT) (1.4% vs 0.7%, p=0.02) and pulmonary embolism (PE) (1.3% vs 0.7%, p=0.002) in patients who underwent OLR compared to MILR. Conclusions Patients who undergo OLR have a higher incidence of postoperative VTE when compared to MILR. This finding is consistent for both DVT and PE.