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Laparoscopic Anterior Right Hepatectomy: A Single-Center Experience
Published on: December 4, 2023
Totally laparoscopic hepatectomy exposing the major vessels
Goro Honda1, Masanao Kurata, Yukihiro Okuda
1Department of Surgery, Tokyo Metropolitan Cancer and Infectious diseases Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan. ghon@cick.jp
Journal of Hepato-Biliary-Pancreatic Sciences
|December 28, 2012
Summary
This study standardized laparoscopic hepatectomy by exposing major vessels, achieving outcomes comparable to open surgery. The technique demonstrated safety and efficacy in 41 patients, with zero mortality and low morbidity.
Area of Science:
- Hepatobiliary Surgery
- Minimally Invasive Surgery
- Surgical Oncology
Background:
- Exposing major vessels is crucial in hepatectomy, including laparoscopic approaches.
- Standardization of laparoscopic hepatectomy techniques is essential for comparable outcomes to open surgery.
Purpose of the Study:
- To present a standardized technique for laparoscopic hepatectomy involving exposure of major vessels.
- To evaluate the safety and efficacy of this standardized laparoscopic hepatectomy procedure.
Main Methods:
- Liver parenchyma was divided without pre-coagulation, using CUSA for vessel exposure.
- Low central venous pressure and Pringle's maneuver were employed for bleeding control.
- The technique was applied in 41 patients over 49 months for various hepatectomy types.
Main Results:
- Median operative time was 361 minutes, with median blood loss of 216 g.
- Conversion rate was 4.9%, postoperative morbidity was 9.8%, and mortality was zero.
- Median hospital stay was 8 days, with no local recurrence observed.
Conclusions:
- The standardized procedure for exposing major vessels significantly improved laparoscopic hepatectomy quality.
- This technique allows laparoscopic hepatectomy to achieve outcomes comparable to open hepatectomy.
