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 17 January 2018

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News

The feasibility of laparoscopic liver resection

A team, based in Créteil, France, has found that laparoscopic liver resections are feasible and safe, and has reported their findings in this month's Annals of Surgery.

News image

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A prospective study of laparoscopic liver resections was undertaken in patients with preoperative diagnoses that included benign lesions, hepatocellular carcinoma with compensated cirrhosis, and metastasis of non-colorectal origin.

Hepatic involvement was limited and located in the left or peripheral right segments (segments 2-6), and the tumor had to be 5 cm or smaller.

Surgical technique included CO2 pneumoperitoneum and liver transection with a harmonic scalpel, with or without portal triad clamping or hepatic vein control. Portal pedicles and large hepatic veins were stapled.

Resected specimens were placed in a bag and removed through a separate incision, without fragmentation.

18 benign lesions and 12 malignant tumors resected

From May 1996 to December 1999, 19% of 159 liver resections were included in the study.

The group resected 18 benign lesions and 12 malignant tumors, including 8 hepatocellular carcinomas in cirrhotic patients. Mean tumor size was 4.25 cm.

There were two conversions to laparotomy (6.6%). The resections included 1 left hepatectomy, 8 bisegmentectomies (2 and 3), 9 segmentectomies and 11 atypical resections.

Mean blood loss was 300ml. Mean surgical time was 214 minutes. There were no deaths, however complications occurred in six patients (20%). Only one cirrhotic patient developed postoperative ascites. No port-site metastases were observed in patients with malignant disease.

Dr Daniel Cherqui a member of the group, concluded that, "Laparoscopic resections are feasible and safe in selected patients with left-sided and right-peripheral lesions requiring limited resection. Young patients with benign disease clearly benefit from avoiding a major abdominal incision, and cirrhotic patients may have a reduced complication rate."

Ann Surg 232: 753-62
24 November 2000

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