Liver resection is an essential component of the management of patients with various primary or metastatic liver cancers, and many of these procedures can now be conducted laparoscopically. Nonetheless, whether hemihepatectomy (the resection of either the entire right or left side of the liver) can also be conducted laparoscopically without compromising oncological outcomes remains to be determined. Now, data from the phase III ORANGE II PLUS trial confirm the feasibility of and demonstrate improved functional recovery with the laparoscopic approach.

A total of 332 patients requiring hemihepatectomy (85% for cancer indications) were randomly allocated (1:1) to undergo either a laparoscopic or open procedure. Among patients with cancer, the majority (50% of the entire cohort) had metastases from colorectal cancer, 22.1% had primary hepatocellular carcinoma and 14.2% had cholangiocarcinoma. Time to functional recovery was the primary end point.