Laparoscopic liver resection: lessons learned after 132 resections

• Published in: Cirugia Española Vol. 91; no. 8; p. 524
• Main Authors: Robles Campos, Ricardo, Marín Hernández, Caridad, Lopez-Conesa, Asunción, Olivares Ripoll, Vicente, Paredes Quiles, Miriam, Parrilla Paricio, Pascual
• Format: Journal Article
• Language: Spanish
• Published: Spain 01.10.2013
• Subjects: Adult; Aged; Aged, 80 and over; Female; Hepatectomy - methods; Hepatectomy - statistics & numerical data; Humans; Laparoscopy; Liver Diseases - surgery; Male; Middle Aged; Young Adult; Cirugía hepática; Cirugía hepática laparoscópica; Metástasis hepáticas; Laparoscopic liver surgery; Hepatic metastases; Tumores hepáticos benignos; Hepatocarcinoma; Liver surgery; Benign liver tumours
• ISSN: 1578-147X
• DOI: 10.1016/j.ciresp.2012.11.002

After 20 years of experience in laparoscopic liver surgery there is still no clear definition of the best approach (totally laparoscopic [TLS] or hand-assisted [HAS]), the indications for surgery, position, instrumentation, immediate and long-term postoperative results, etc. To report our experience in laparoscopic liver resections (LLRs). Over a period of 10 years we performed 132 LLRs in 129 patients: 112 malignant tumours (90 hepatic metastases; 22 primary malignant tumours) and 20 benign lesions (18 benign tumours; 2 hydatid cysts). Twenty-eight cases received TLS and 104 had HAS. 6 right hepatectomies (2 as the second stage of a two-stage liver resection); 6 left hepatectomies; 9 resections of 3 segments; 42 resections of 2 segments; 64 resections of one segment; and 5 cases of local resections. There was no perioperative mortality, and morbidity was 3%. With TLS the resection was completed in 23/28 cases, whereas with HAS it was completed in all 104 cases. Transfusion: 4,5%; operating time: 150min; and mean length of stay: 3,5 days. The 1-, 3- and 5-year survival rates for the primary malignant tumours were 100, 86 and 62%, and for colorectal metastases 92, 82 and 52%, respectively. LLR via both TLS and HAS in selected cases are similar to the results of open surgery (similar 5-year morbidity, mortality and survival rates) but with the advantages of minimally invasive surgery.