No abstract

Objectives: To compare King Saud University Medical City experience in laparoscopic liver resection with our previously established database for open resections. Methods: A retrospective study was conducted at King Saud University Medical City, Riyadh, Saudi Arabia. All adult patients who underwent liver resection from 2006 to 2017 were included. Patients who had their procedure converted to open were excluded. Results: Among the 111 liver resections included, 22 (19.8%) were performed laparoscopically and 89 (80.1%) were performed using the open technique. Malignancy was the most common indication in both groups (78.5%). The mean operative time was 275 min (SD 92.2) in the laparoscopic group versus 315 min (SD 104.3) in the open group. Intraoperative blood transfusion was required in the laparoscopic (9%) and open groups (31.4%). The morbidity rate was 13.6% in the laparoscopic group and 31.4% in the open group, and the mortality rate was 0% in the laparoscopic group and 5.6% in the open group. Conclusion: Laparoscopic liver resection appears to be a safe technique and can be performed in various benign and malignant cases.

A woman in her mid-30s presented with upper right quadrant abdominal pain. On examination, there was mild upper right quadrant tenderness and negative Murphy's sign. Basic laboratory investigations revealed normal results except for elevated alkaline phosphatase. Subsequent imaging revealed chronic calculous cholecystitis and the dilated common bile duct harbouring stones, with pneumobilia. The patient underwent open cholecystectomy with common bile duct exploration. Intraoperatively, the gallbladder was found contracted, and densely adherent to and fistulising with the common bile duct and stomach.

GTU can achieve a simple and secure LAG, avoiding the catastrophic complications of intraabdominal leak without the need of special instruments or enlarging the port's wound. Using a smaller wound and intraabdominally placed mucosa helps in minimizing the risk of wound infection and external leak. Transient complications are expected during the earlier phase of the learning curve.