Experience of Total Laparoscopic Hepatectomy

Kim, Chang Gyun; Yoon, Yoo Seok; Han, Ho Seong; Shin, Sang Hyun; Chun, Kwang Sik; Jang, Jin Young; Suh, Kyung Suk; Kim, Sun Whe; Lee, Kuhn Uk; Park, Yong Hyun

Abstract

PURPOSE: The aim of this study is to assess the feasibility and clinical outcomes of laparoscopic liver resection by reviewing our experience of laparoscopic liver resection performed in a single institution.
METHODS
We retrospectively analyzed the clinical outcome of 64 patients that had undergone laparoscopic liver resection for various liver diseases between May 2003 and June 2006.
RESULTS
The patients were composed of 36 men and 28 women, with a mean age of 56.9 years. Indications for laparoscopic liver resection included 37 cases of a tumor (20 hepatocellular carcinomas, 8 metastatic cancers and 9 benign tumors) and 25 cases of IHD stones. The surgical procedures were 19 tumorectomy cases, 24 left lateral sectionectomy cases, 15 left hepatectomy cases, 4 right posterior sectionectomy cases and 2 right hepatectomy cases. The mean surgical time was 280.3 minutes. Intraoperative transfusion was required for 18 patients (28.1%). There was one postoperative death (1.6%) due to biliary sepsis after a left lateral sectionectomy for an IHD stone. Postoperative complications developed in 9 cases (14.0%) (2 intraabdominal abscesses, 1 hematoma, 1 bile leakage, 1 ascites, 1 gastric variceal bleeding, 1 ulcer bleeding and 1 anastomosis leakage), all of which were improved by conservative management. The mean postoperative hospital stay was 11.0 days.
CONCLUSION
Our experience shows that laparoscopic liver resection is a feasible operation and is comparable to surgery with the open method. However, a prospective comparative study with long term follow-up is needed to confirm the equivalence of the procedures.