Lessons from laparoscopic liver surgery: a nine-year case series

Abstract

Objective: This series describes a developing experience in laparoscopic liver surgery presenting results from 40 procedures including right hemihepatectomy, left lateral lobectomy, and microwave ablation therapy.

Methods: Forty patients undergoing laparoscopic liver surgery between September 1997 and November 2006 were included. The data set includes: operative procedure and duration, intraoperative blood loss, conversion to open operation rates, length of hospital stay, complications, mortality, histology of lesions/resection margins, and disease recurrence.

Results: Mean age of patient: 59 years, 17/40 male, 23/40 female, 23/40 of lesions were benign, and 17/40 malignant. Operations included: laparoscopic anatomical resections n = 15, nonanatomical resections n = 11, microwave ablations n = 8 and deroofing of cysts n = 7. Median anaesthetic time: 120 minutes (range 40-240), mean blood loss 78 mL and 1/40 conversions to open. Median resection margins were 10 mm (range 1-14) and median length of stay 3 days (range 1-10). Operative and 30-day mortality were zero with no local disease recurrence.

Conclusion: Laparoscopic liver surgery appears safe and effective and is associated with reduced hospital stay. Larger studies are required to confirm it is oncologically sound.

Figure 1

Graph showing the number of laparoscopic liver procedures per year 1997-2006.