Initial experience with laparoscopic hepatic resection at a comprehensive cancer center

Area of Science:

• Hepatobiliary Surgery
• Minimally Invasive Surgery
• Surgical Oncology

Background:

• Advanced minimally invasive surgery (MIS) training is increasingly available for complex hepatic, pancreatic, and biliary (HPB) procedures.
• This study reviews the initial experience of a surgeon with advanced MIS HPB training at a national cancer center.

Purpose of the Study:

• To evaluate the feasibility and outcomes of laparoscopic hepatectomy in a surgeon with advanced MIS HPB training.
• To assess the learning curve and complication rates associated with laparoscopic liver resections.

Main Methods:

• Retrospective review of the first 50 laparoscopic hepatectomies for cancer performed by a trained surgeon.
• Inclusion criteria: cases initiated with the intent to complete laparoscopically.

Main Results:

• Out of 57 total hepatectomies, 53 were attempted laparoscopically, with 46 (87%) completed successfully.
• Mean operative time was 265 minutes, mean blood loss was 300 ml, and mean hospital stay was 7 days.
• Complication rate was 11%, including bile leaks and hemorrhages requiring conversion.

Conclusions:

• Surgeons with advanced MIS HPB training can achieve a high rate of successful laparoscopic hepatectomies.
• Comprehensive training in both open and laparoscopic HPB surgery is recommended prior to performing these advanced techniques.