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Updated: Dec 20, 2025
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Application of the En Bloc Concept Combined with Anatomic Resection in Laparoscopic Hepatectomy
Published on: March 10, 2023
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Laparoscopic hepatic lobectomy for symptomatic polycystic liver disease
Amy Y Li1, John R Bergquist1, Auriel T August1
1Department of Surgery, Section of Surgical Oncology, Stanford University, Stanford, CA, USA.
Summary
Laparoscopic hepatectomy for polycystic liver disease (PCLD) offers superior volume reduction compared to open surgery. This minimally invasive approach achieves comparable results to open resections with acceptable postoperative morbidity.
Area of Science:
- Hepatobiliary surgery
- Minimally invasive surgery
- Polycystic liver disease (PCLD) management
Background:
- Laparoscopic fenestration is standard for liver cysts, but open hepatectomy remains common for polycystic liver disease (PCLD).
- Limited outcome data exists for laparoscopic hepatectomy in PCLD patients.
Purpose of the Study:
- To compare outcomes of laparoscopic versus open hepatectomy for polycystic liver disease (PCLD).
- To evaluate volume reduction, re-admission rates, and postoperative complications.
Main Methods:
- Retrospective review of 26 PCLD patients (2010-2019) undergoing surgery.
- Patients categorized by operative approach: laparoscopic fenestration, laparoscopic hepatectomy, open hepatectomy, liver transplantation.
- Primary outcomes: pre- and post-operative volume reduction, re-admission, and complications.
Main Results:
- Laparoscopic hepatectomy resulted in a 56% volume reduction, exceeding open hepatectomy's 32%.
- Median length of stay for laparoscopic resection was 3 days with no readmissions.
- One patient experienced post-operative atrial fibrillation; overall morbidity was low.
Conclusions:
- Laparoscopic hepatectomy for PCLD achieves significant volume reduction, comparable to published open resection series.
- Minimally invasive laparoscopic hepatectomy provides adequate volume reduction with acceptable postoperative morbidity.
