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Laparoscopic liver resections: a feasibility study in 30 patients
D Cherqui1, E Husson, R Hammoud
1Departments of General and Digestive Surgery and Anesthesiology, H opital Henri Mondor-Université Paris XII, Créteil, France. daniel.cherqui@hmn.ap-hop-paris.fr
Annals of Surgery
|November 23, 2000
Summary
Laparoscopic liver resections are feasible and safe for selected patients with limited lesions. This minimally invasive approach offers benefits, particularly for younger patients with benign disease and potentially reduced complications for cirrhotic patients.
Area of Science:
- Minimally invasive surgery
- Hepatobiliary surgery
- Surgical oncology
Background:
- Laparoscopic liver resections are technically challenging, limiting their application.
- Advancements in laparoscopic techniques and technology enable their use in select cases.
Purpose of the Study:
- To evaluate the feasibility and safety of laparoscopic liver resections.
- To assess outcomes in patients with benign lesions, hepatocellular carcinoma, and noncolorectal metastases.
Main Methods:
- Prospective study of 30 laparoscopic liver resections (May 1996-Dec 1999).
- Inclusion criteria: limited lesions (≤5 cm) in segments 2-6, benign or malignant.
- Techniques: CO2 pneumoperitoneum, harmonic scalpel, optional clamping, specimen retrieval in a bag.
Main Results:
- 19% of liver resections were laparoscopic; 18 benign, 12 malignant tumors (8 HCC in cirrhotic patients).
- Mean tumor size 4.25 cm; 6.6% conversion rate to laparotomy.
- No deaths; 20% complication rate, including one case of ascites in a cirrhotic patient. No port-site metastases.
Conclusions:
- Laparoscopic liver resection is feasible and safe for selected patients with peripheral lesions.
- Benefits include avoiding major incisions for benign disease and potentially lower complication rates for cirrhotic patients.