Single center experience of laparoscopic hepatectomy: the comparison of perioperative outcomes between early and late period

ABSTRACT

BACKGROUNDS/AIMS: The aim of this study is to clarify the safety and feasibility of laparoscopic hepatectomy, through comparing the early and late periods of perioperative outcomes. METHODS: We retrospectively analyzed 138 patients who underwent laparoscopic hepatectomy from January 2003 to June 2011, at Yeungnam University Hospital. We divided the total patients to early period (from January 2003 to February 2007, n=49) and late period (from March 2007 to June 2011, n=89) groups and compared the perioperative outcomes including the mean operation time, intra-operative blood loss, postoperative hospital stay, intensive care unit (ICU) stay, and duration of liver function test (LFT) normalization. RESULTS: The mean operation time was 308 minutes (range 140-510) in the early group and 193 minutes (range 40-350) in the late period group (p<0.001). The mean intraoperative blood loss was 171 ml (range 50-1,200) in the early and 44 ml (range 0-400) in the late group (p=0.005). The postoperative hospital stay was 9.7 days (range 4-31) in the early and 6.8 days (range 2-9) in the late period (p<0.001). The ICU stay hour was 21.6 hours (range 0-120) in the early and 2.8 hour (range 0-24) in the late period (p<0.001). The duration of LFT normalization was 5.7 days (range 0-39) in the early and 2.1 days (range 0-20) in the late period (p=0.003). The perioperative outcomes in the late period were better than the early period, which showed a statistically significant difference. CONCLUSIONS: Laparoscopic hepatectomy is feasible and can be safely performed in selected patients but requires a long experience in open liver resection and mastery of laparoscopic surgical skills.