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Laparoscopic Anterior Right Hepatectomy: A Single-Center Experience
Published on: December 4, 2023
Experience with more than 500 minimally invasive hepatic procedures
Joseph F Buell1, Mark T Thomas, Steven Rudich
1Jewish Transplant Center, Division of Transplantation, Department of Surgery, University of Louisville, Louisville, KY 40202, USA. joseph.buell@louisville.edu
Annals of Surgery
|September 16, 2008
Summary
Minimally invasive liver surgery, including radiofrequency ablation (RFA) and resection, offers outcomes comparable or superior to open surgery. Laparoscopic HR demonstrated superiority over RFA for cancer treatment with lower recurrence rates.
Area of Science:
- Hepatobiliary surgery
- Minimally invasive surgery
- Surgical oncology
Background:
- Minimally invasive liver surgery is safe and effective.
- A programmatic approach to minimally invasive liver surgery is needed.
Purpose of the Study:
- Evaluate experience with over 500 minimally invasive hepatic procedures.
- Compare outcomes of different minimally invasive techniques.
Main Methods:
- Retrospective review of 590 procedures (2001-2008).
- Groups: laparoscopy with biopsy, laparoscopic radiofrequency ablation (RFA), minimally invasive resection.
- Analyzed complications, recurrence, mortality, and cost.
Main Results:
- Comparable complication and mortality rates for RFA and resection.
- Higher complication and mortality rates in cirrhotic patients undergoing resection.
- Similar overall recurrence rates for RFA (24%) and resection (23%).
- Higher local recurrence rates for RFA (6.3%) vs. resection (1.5%).
Conclusions:
- Minimally invasive hepatic surgery is a viable alternative to open surgery.
- Laparoscopic HR shows superiority over RFA for cancer treatment, with lower local recurrence.
- RFA is effective for bridging patients to liver transplantation.