Evidence map›Paper›PMID 41803352›Full record

Trial reportSurgical endoscopy2026

Laparoscopic versus open hemihepatectomy: does side matter? A post-hoc analysis of the ORANGE II PLUS randomized controlled trial.

Bram Olij, Gabriela Pilz da Cunha, Francesca Ratti, Mohammad Abu Hilal, Roberto I Troisi, Robert P Sutcliffe, Marc G Besselink, Somaiah Aroori, Krishna V Menon, Bjørn Edwin and 24 more

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter StudyComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01441856 (The ORANGE II PLUS - Trial), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01441856 nacompletednot on this map

The ORANGE II PLUS - Trial: an International Multicenter Randomized Controlled Trial of Open Versus Laparoscopic Hemihepatectomies.

TypeinterventionalSponsorMaastricht University Medical CenterRan2013 to 2023Enrolled350ConditionsLiver Lesions Requiring HemihepatectomyArmsOpen or Laparoscopic left hemihepatectomy, Open or Laparoscopic right hemihepatectomy
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

34 authors.

Bram OlijDepartment of Surgery and Transplantation, Maastricht University Medical Centre+, PO Box 5800, 6202 AZ, Maastricht, The Netherlands. Bram.olij@mumc.nl.ORCID http://orcid.org/0000-0002-1027-8685
Gabriela Pilz da CunhaDepartment of Surgery, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands.
Francesca RattiHepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy.
Mohammad Abu HilalDepartment of Surgery, School of Medicine, The University of Jordan, Amman, 11942, Jordan.
Roberto I TroisiDivision of HPB, Minimally Invasive and Robotic Surgery, Department of Clinical Medicine and Surgery, Transplantation Service, Federico II University, Naples, Italy.
Robert P SutcliffeHPB and Liver Transplant Unit, University Hospitals Birmingham NHS Trust, Birmingham, UK.
Marc G BesselinkDepartment of Surgery, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands.
Somaiah ArooriDepartment of Surgery, Plymouth Hospitals NHS Trust, Plymouth, UK.
Krishna V MenonDepartment of Liver Transplant and HPB Surgery, Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, UK.
Bjørn EdwinIntervention Centre and Department of Hepatic, Pancreatic and Biliary Surgery, Oslo University Hospital and Institute of Clinical Medicine, University Hospital of Oslo, Oslo, Norway.
Mathieu D'HondtDepartment of Digestive and Hepatobiliary/Pancreatic Surgery, AZ Groeninge, Kortrijk, Belgium.
Valerio LucidiDepartment of Digestive Surgery, Unit of Hepatobiliary Surgery and Transplantation, Hôpitaux Universitaires de Bruxelles, Hôpital Erasme, Brussels, Belgium.
Tom F UlmerDepartment of Surgery and Transplantation, Maastricht University Medical Centre+, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
Rafael Díaz-NietoDepartment of Hepato-Biliary Surgery, Aintree University Hospital NHS Foundation Trust, Liverpool, UK.
Zahir SoonawallaDepartment of Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Steve WhiteDepartment of Surgery, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.
Gregory SergeantDepartment of Abdominal Surgery, Jessa Hospital, Hasselt, Belgium.
Christoph KuemmerliUniversity Surgery and Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton/University of Southampton, Southampton, UK.
Remon KorenblikDepartment of Surgery and Transplantation, Maastricht University Medical Centre+, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
Vincenzo ScuderiDepartment of General, HPB and Liver Transplantation Surgery, Ghent University Hospital, Ghent, Belgium.
Frederik BerrevoetDepartment of General, HPB and Liver Transplantation Surgery, Ghent University Hospital, Ghent, Belgium.
Aude VanlanderDepartment of General, HPB and Liver Transplantation Surgery, Ghent University Hospital, Ghent, Belgium.
Ravi MarudanayagamHPB and Liver Transplant Unit, University Hospitals Birmingham NHS Trust, Birmingham, UK.
Pieter J TanisDepartment of Surgery, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands.
Marielle M E CoolsenDepartment of Surgery and Transplantation, Maastricht University Medical Centre+, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
Robert S FichtingerDepartment of Surgery and Transplantation, Maastricht University Medical Centre+, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
Zina B EmintonSouthampton Clinical Trials Unit, University of Southampton, Southampton, UK.
Ulf P NeumannDepartment of Surgery and Transplantation, Maastricht University Medical Centre+, PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
Lloyd BrandtsDepartment of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre+, Maastricht, the Netherlands.
Siân A PughDepartment of Oncology, Addenbrooke's Hospital, Cambridge, UK.
Åsmund A FretlandIntervention Centre and Department of Hepatic, Pancreatic and Biliary Surgery, Oslo University Hospital and Institute of Clinical Medicine, University Hospital of Oslo, Oslo, Norway.
John N PrimroseUniversity Surgery and Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton/University of Southampton, Southampton, UK.
Ronald M van DamDepartment of Surgery and Transplantation, Maastricht University Medical Centre+, PO Box 5800, 6202 AZ, Maastricht, The Netherlands. r.van.dam@mumc.nl.
ORANGE II PLUS Collaborative

Funding

Cancer Research UK 12 - 048
6 · The paper itself

Abstract

backgroundLaparoscopic liver surgery offers several benefits, yet the adoption of laparoscopic right hemihepatectomy (RH) is slow, owing to its high degree of technical complexity. It is uncertain whether the general benefits of laparoscopy also extend to RH. This study evaluates perioperative outcomes of laparoscopic vs open RH, and illustrates differences in laparoscopic RH and left hemihepatectomy (LH) within the international, multicentre, double-blinded ORANGE-II-PLUS randomized trial.

methodsPatients were randomly assigned to open (n = 166) or laparoscopic hemihepatectomy (n = 166). The present post-hoc subgroup analysis compares perioperative and oncological outcomes of laparoscopic RH (n = 105) vs open RH (n = 108). In addition, interaction between surgical approach (open or laparoscopic) and hemihepatectomy laterality (RH; n = 213 vs LH; n = 119) was assessed.

resultsThere was a higher proportion of malignancy, including more colorectal liver metastases, and more preoperative portal vein embolization in patients undergoing RH compared to LH, other characteristics were well-balanced. The laparoscopic approach was associated with shorter time to functional recovery compared to open surgery for RH (median 5 vs 5 days, p = .004) and shorter length of hospital stay (median 5 vs 6 days, p = .014). Except for longer operating times in laparoscopy (332 vs 263 min, p < .001), no differences were found in other perioperative and oncological outcomes between laparoscopic and open RH. For all outcomes, interaction testing between surgical approach and laterality did not reach significance, suggesting that approach did not affect RH and LH differently. Though patients requiring laparoscopic RH needed longer operating time (332 vs 225 min) and time to functional recovery (median 5 vs 3 days) than patients requiring laparoscopic LH.

conclusionPatients undergoing RH showed modest, population-level, benefits from a laparoscopic approach with regard to time to functional recovery and hospital length of stay, despite higher technical complexity and a more pronounced postoperative impact on the patient. Interaction testing between RH and LH did not reach significance, suggesting the effect of the approach on outcomes were consistent regardless of resection laterality. These results support the implementation of the laparoscopic approach for RH if surgeons are experienced. CLINICAL TRIAL INFORMATION: NCT01441856.

Indexed as

HepatectomyLaparoscopyLiver NeoplasmsAgedDouble-Blind MethodFemaleHumansLength of StayMaleMiddle AgedOperative TimeTreatment OutcomeLaparoscopic hepatectomyLeft hemihepatectomyMinimally invasive liver surgeryRandomized controlled trialRight hemihepatectomy

Identifiers

PMID41803352
PMCPMC13161259

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.