Early results of liver resection using laparoscopic technique

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The aim of the study was to present early outcomes of liver resection using laparoscopic technique.

Material and methods. Retrospective analysis of patients who underwent liver resection using laparoscopic method was conducted. The analyzed group included 23 patients (11 women and 12 men). An average patient age was 61.3 years (37 – 83 years). Metastases of the colorectal cancer to the liver were the cause for qualification to the procedure of 15 patients, metastasis of breast cancer in 1 patient and primary liver malignancy in 5 patients. The other 2 patients were qualified to the liver resection to widen the surgical margins due to gall-bladder cancer diagnosed in the pathological assessment of the specimen resected during laparoscopic cholecystectomy, initially performed for other than oncology indications.

Results. Hemihepatectomy was performed in 11 patients (9 right and 2 left), while the other 12 patients underwent minor resection procedures (5 metastasectomies, 4 nonanatomical liver resections, 1 bisegmentectomy, 2 resections of the gall-bladder fossa). An average duration of the surgical procedure was 275 minutes 65 – 600). An average size of the resected tumors was 28 mm (7 – 55 mm). In three cases conversion to laparotomy occurred, caused by excessive bleeding from the liver parenchyma. Postoperative complications were found in 4 patients (17.4%). Median hospitalization duration was 6 days (2 – 130 days). One patient (4.3%) was rehospitalized due to subhepatic abscess and required reoperation. Histopathology assessment confirmed radical resection (R0) in all patients in our group.

Conclusion. Laparoscopic liver resections seem to be an interesting alternative in the treatment of focal lesions in the liver.

1. Bryant R, Laurent A, Tayar C et al.: Laparoscopic liver resection-understanding its role in current practice: the Henri Mondor Hospital experience. Ann Surg 2009; 250: 103-11.

2. Kurosaki I, Yamamoto S, Kitami C et al.: Video-assisted living donor hemihepatectomy through a 12-cm incision for adult-to-adult liver transplantation. Surgery 2006; 139: 695-703.

3. Buell JF, Thomas MT, Rudich S et al.: Experience with more than 500 minimally invasive hepatic procedures. Ann Surg 2008; 248: 475-86.

4. Martin RC, Scoggins CR, McMasters KM: Laparoscopic hepatic lobectomy: advantages of a minimally invasive approach. J Am Coll Surg 2010; 210: 627-34, 634-36.

5. Gagner M, Rheault M, Dubuc J: Laparoscopic partial hepatectomy for liver tumor. Surg Endoscopic 1993; 6: 99.

6. Nguyen KT, Gamblin TC, Geller DA: World review of laparoscopic liverresection-2,804 patients. Ann Surg 2009; 250(5): 831-41.

7. Dagher I, O'Rourke N, Geller DA et al.: Laparoscopic major hepatectomy: an evolution in standard of care. Ann Surg 2009; 250(5): 856-60.

8. Topal B, Fieuws S, Aerts R et al.: Laparoscopic versus open liver resection of hepatic neoplasms: comparative analysis of short-term results. Surg Endosc 2008; 22(10): 2208-13.

9. Harimoto N, Shirabe K, Ikegami T et al.: Postoperative complications are predictive of poor prognosis in hepatocellular carcinoma. J Surg Res 2015; 199(2): 470-77.

10. Xiao L, Xiang LJ, Li JW et al.: Laparoscopic versus open liver resection for hepatocellular carcinoma in posterosuperior segments. Surg Endosc 2015; 29(10): 2994-2300.

11. Jackson NR, Hauch A, Hu T et al.: The safety and efficacy of approaches to liver resection: a meta-analysis. JSLS 2015; 19(1): e2014. 00186.

12. Alkhalili E, Berber E: Laparoscopic liver resection for malignancy: a review of the literature. World J Gastroenterol 2014; 20(37): 13599-606.

13. Nomi T, Fuks D, Kawaguchi Y et al.: Learning curve for laparoscopic major hepatectomy. Br J Surg 2015; 102(7): 796-804.

14. Castaing D, Vibert E, Ricca L at al.: Oncologic results of laparoscopic versus open hepatectomy for colorectal liver metastases in two specialized centers. Ann Surg 2009; 250(5): 849-55.

15. Truant S, Bouras AF, Hebbar M et al.: Laparoscopic resection vs. open liver resection for peripheral hepatocellular carcinoma in patients with chronic liver disease: a case-matched study. Surg Endosc 2011; 25(11): 3668-77.

16. Lee KF, Chong CN, Wong J et al.: Long-term results of laparoscopic hepatectomy versus open hepatectomy for hepatocellular carcinoma: a case-matched analysis. World J Surg 2011; 35(10): 2268-74.

17. Hu M, Zhao G, Xu D et al.: Retroperitoneal laparoscopic hepatectomy: a novel approach. Surg Laparosc Endosc Percutan Tech 2011; 21(5): e245-8.

18. Topal B: Minimally invasive liver surgery for metastases from colorectal cancer: oncologic outcome and prognostic factors. Surg Endosc 2013; 27(6): 2249.

19. Pędziwiatr M, Matłok M, Kisialeuski M et al.: Enhanced recovery (ERAS) protocol in patients undergoing laparoscopic total gastrectomy. Wideochir Inne Tech Maloinwazyjne 2014; 9(2): 252-57.

20. Blind PJ, Andersson B, Tingstedt B et al.: Fasttrack program for liver resection – factors prolonging length of stay. Hepatogastroenterology 2014; 61(136): 2340-44.

21. Hughes MJ, McNally S, Wigmore SJ: Enhanced recovery following liver surgery: a systematic review and meta-analysis. HPB (Oxford) 2014; 16(8): 699-706.

22. Rao A, Rao G, Ahmed I: Laparoscopic vs. open liver resection for malignant liver disease. A systematic review. Surgeon 2012; 10(4): 194-201.

23. Ciria R, Cherqui D, Geller DA et al.: Comparative Short-term Benefits of Laparoscopic Liver Resection: 9000 Cases and Climbing. Ann Surg 2015; 27: (Epubahead of print)

Polish Journal of Surgery

The Journal of Foundation of the Polish Journal of Surgery

Journal Information

CiteScore 2016: 0.29

SCImago Journal Rank (SJR) 2016: 0.166
Source Normalized Impact per Paper (SNIP) 2016: 0.207


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