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Case Reports
. 2011 Jan;13(1):46-50.
doi: 10.1111/j.1477-2574.2010.00238.x. Epub 2010 Nov 25.

Laparoscopic major hepatectomy can be safely performed with colorectal surgery for synchronous colorectal liver metastasis

Hadrien Tranchart  1 , Papa Saloum Diop, Panagiotis Lainas, Guillaume Pourcher, Laurence Catherine, Dominique Franco, Ibrahim Dagher
Affiliations
Case Reports

Laparoscopic major hepatectomy can be safely performed with colorectal surgery for synchronous colorectal liver metastasis

Hadrien Tranchart et al. HPB (Oxford). 2011 Jan.

Abstract

Background: The optimal strategy for resectable synchronous colorectal liver metastases remains controversial. Although some authors advocate a staged treatment, an increasing number of studies have reported that combined colorectal and liver resection is safe. Laparoscopic combined resection in primary colorectal cancer with synchronous liver metastases has been reported but there are no specific data for major liver resections. In the present study, we evaluated the feasibility of a simultaneous entirely laparoscopic procedure, in the light of the benefits of laparoscopy in both colon and liver surgery, and discussed the benefits of this strategy.

Methods: Two cases are presented of totally laparoscopic major liver resections associated with laparoscopic colorectal resections for synchronous liver metastases with the emphasis on the technical aspects. Duration of surgery, blood loss and post-operative outcome were evaluated.

Results: Laparoscopic right hepatectomy or left hepatectomy with simultaneous colon resection for liver metastasis was feasible and safe with only one suprapubic 5-mm trocar added to the usual trocar sites. The mean duration of surgery was 327 min with a mean estimated blood loss of 200 ml. The post-operative course was uneventful.

Discussion: In selected patients, laparoscopic major hepatectomies for unilobular synchronous metastases can be safely performed simultaneously with colorectal surgery.

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Figures

Figure 1
Figure 1
Computed tomography showing the lesion in the right liver of patient 1
Figure 2
Figure 2
Trocars placement for laparoscopic right or left hepatectomy combined with a colonic resection
Figure 3
Figure 3
Computed tomography showing the tumour in left liver of patient 2
Figure 4
Figure 4
(a) Parenchymal transection during a left hepatectomy, performed with a thermofusion device. (b) The hepatic vein previously controlled with a vessel loop (black arrow) is sectioned at the end of liver division
See this image and copyright information in PMC

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