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Minor laparoscopic liver resection: toward 1-day surgery?
Nicola de'Angelis1, Benjamin Menahem2,3, Philippe Compagnon1
1Unit of Digestive, Hepato-Pancreato-Biliary Surgery, and Liver Transplantation, Henri Mondor Hospital, AP-HP, Université Paris Est-UPEC, Address: 51, Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France.
Surgical Endoscopy
|April 6, 2017
Summary
Early discharge after minor laparoscopic liver resection (LLR) is feasible and safe for selected patients. This protocol minimizes hospitalization impact while maintaining patient safety and successful recovery.
Area of Science:
- Hepatobiliary Surgery
- Minimally Invasive Surgery
- Surgical Outcomes
Background:
- Advancements in laparoscopy and enhanced recovery after surgery (ERAS) programs reduce hospital stays.
- The need to evaluate early discharge protocols for minor laparoscopic liver resection (LLR).
Purpose of the Study:
- To explore the feasibility and safety of an early discharge protocol following minor laparoscopic liver resection (LLR).
Main Methods:
- Inclusion of patients undergoing minor LLR for benign or malignant lesions (≤2 segments).
- Discharge within 24 hours for patients meeting specific criteria (fitness, proximity, caregiver availability).
- Standardized patient/caregiver education and 24-hour support line.
Main Results:
- 24 patients (mean age 48.9 years, 87.5% ASA I/II) included; 46% had malignant lesions.
- Zero mortality, no transfusions, conversions, or pedicule clamping; no anesthesia complications.
- All patients discharged at 24 hours; one readmission (4.2%) for wound abscess treated with antibiotics.
Conclusions:
- A standardized protocol enables successful early discharge after minor LLR in highly selected patients.
- This approach has minimal impact on primary healthcare services while ensuring patient safety.