Current status of laparoscopic liver surgery in Japan: results of a multicenter Japanese experience

Abstract

Purpose: Laparoscopic liver surgery is widely performed around the world, and surgeons recognize its feasibility. We herein report the current status of laparoscopic liver surgery in Japan.

Methods: A questionnaire survey was conducted at 761 hospitals, including 41 member hospitals of the Japanese Endoscopic Liver Surgery Study Group and 720 facilities certified by the Japanese Society of Gastroenterological Surgery. Four hundred ninety-one hospitals responded to the questionnaire (response rate: 64 %). The data collected from 2,259 patients in 124 hospitals that reported performing laparoscopic liver resection were used. The surgical procedures and intraoperative complications, including the rate of conversion to open surgery, and morbidity rates were analyzed.

Results: Pure laparoscopic procedures were performed in 1,346 patients (59.6 %), hand-assisted procedures in 174 (7.7 %) and hybrid procedures in 739 (32.7 %). Laparoscopic hepatectomy was performed in 1,982 patients (87.7 %): hemihepatectomy in 141 (7.1 %), sectionectomy in 87 (4.4 %), left lateral sectionectomy in 208 (10.5 %), segmentectomy in 91 (4.6 %) and non-anatomical partial resection in 1,248 (63.0 %). A total of 45 procedures (2.3 %) were converted to conventional open surgery. Postoperative complications occurred in 91 patients (4.6 %).

Conclusions: Laparoscopic liver surgery is a safe, feasible procedure for treating liver disease in carefully selected patients.