Laparoscopic Liver Resection: A Single Center Experience

ABSTRACT

BACKGROUND: An increasing number of small prospective studies have been published, since the first report of laparoscopic liver resection by Gagner et al. in 1992. They have shown encouraging results for the feasibility and safety of the procedure. This paper provides a retrospective analysis of a single center's experience with elective laparoscopic liver resections. METHODS: We did a retrospective study on laparoscopic liver resections performed from July 2005 to April 2009, undertaken in 34 patients with preoperative diagnosis of a benign lesion (7 cases, 20.6%), hepatocellular carcinoma in absence of complicated cirrhosis (18 cases, 52.9%), or liver metastasis (9 cases, 26.4%). The mean tumor size was 2.63+/-1.57 cm (range 0.55-7.5) RESULTS: We carried out 15 wedge resections (44.1%), 3 right hemi-hepatectomies (8.8%), 4 left hemi-hepatectomies (11.8%), 5 liver segmentectomies (14.7%), 7 left lateral sectionectomies (20.6%). The average duration of an operation was 175.00+/-129.12 minutes. There were 6 patients (15%) in which a conversion to laparotomy was required none of the conversions occurred under emergency situations. Intraoperative transfusion was required for 5 patients (14.7%). Postoperative complications developed in 2 patients (5.8%) (1 intraabdominal abscess, 1 bile leakage). There were no deaths and no reoperations for complications. The mean postoperative hospital stay was 9.9 days. CONCLUSION: Our experience shows that laparoscopic liver resections, including major hepatectomies, are feasible and safe. Nonetheless, a prospective randomization study with a greater number of cases and longer follow-up is needed before laparoscopic liver resection can be regarded as the gold-standard approach for hepatic lesions.