Surgical outcomes following laparoscopic major hepatectomy for various liver diseases

Kang, Sung-Hwa; Kim, Ki‐Hun; Shin, Min‐Ho; Yoon, Young‐In; Kim, Wan‐Jun; Jung, Dong‐Hwan; Park, Gil‐Chun; Ha, Tae‐Yong; Lee, Sung‐Gyu

doi:10.1097/md.0000000000005182

Cited by 20 publications

(12 citation statements)

References 37 publications

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“…[23–25] Although the high vascularity of the liver parenchyma makes the operation technically very challenging, there are many advantages of LRR. [14] In our institution, more than 100 liver transplantations, 200 LLRs, and 700 OLRs are done annually.…”

Section: Discussionmentioning

confidence: 99%

Surgical outcomes of laparoscopic versus open liver resection for hepatocellular carcinoma for various resection extent

Chen

Liu

et al. 2017

Medicine

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Although the number of laparoscopic liver resections (LRRs) has increased, studies of surgical outcomes in comparison with the conventional open approach are limited. The purpose of this study was to analyze the surgical outcomes (safety and efficacy) of LLR versus open liver resection (OLR) for hepatocellular carcinoma (HCC).We collected data on all patients who received liver resection for HCC between April 2015 and September 2016 in our institution, and retrospectively investigated the demographic and perioperative data, and also surgical outcomes.Laparoscopic liver resection was performed in 225 patients and OLR in 291. In patients who underwent minor hepatectomy, LLR associated with a shorter duration of operation time (200 vs 220 minutes; P < 0.001), less blood loss (100 vs 225 mL; P < 0.001), lower transfusion rate (3.0% vs 12.0%; P = 0.012), and shorter postoperative hospital stay (6 vs 7 days; P < 0.001) compared with OLR. Dietary recovery was relatively fast in the group of LLR, but there were no significant differences in hepatic inflow occlusion rate, complication rate, and transfusion volume. Patients who received major hepatectomy had a longer duration of operation (240 vs 230 minutes; P < 0.001), less blood loss (200 vs 400 mL; P < 0.001), lower transfusion rate (4.8% vs 16.5%; P = 0.002), lower hepatic inflow occlusion rate (68.3% vs 91.7%; P < 0.001), and shorter postoperative hospital stay (6 vs 8 days; P < 0.001). Complication rate (P = 0.366) and transfusion volume (P = 0.308) did not differ between groups.Laparoscopic liver resection is a feasible and safe alternative to OLR for HCC when performed by a surgeon experienced with the relevant surgical techniques, associated with less blood loss, lower transfusion rate, a rapid return to a normal diet, and shorter postoperative hospital stay with no compromise in complications. Further, long-term follow-up should be acquired for adequate evaluation for survival.

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Section: Discussionmentioning

confidence: 99%

Surgical outcomes of laparoscopic versus open liver resection for hepatocellular carcinoma for various resection extent

Chen

Liu

et al. 2017

Medicine

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“…Tumors that were bilateral, large (>10 cm), involved major hepatic or portal veins, or were located within 1 cm of the hepatic hilum or inferior vena cava (IVC) were excluded for laparoscopic major hepatectomy. This exclusion criteria are very similar to those of the Asan Medical Center, Seoul, Korea 11…”

Section: Methodsmentioning

confidence: 99%

Early experience of laparoscopic liver resection: A single institution experience with 37 consecutive cases

Jang

Kim

2019

Ann Hepatobiliary Pancreat Surg

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Backgrounds/Aims Laparoscopic liver resection (LLR) has evolved and broadened in scope. While open liver resections are currently being performed safely in our hospital, LLRs are being implemented in fewer cases. The aim of this study was to review our initial experience in LLR to assess early outcomes of the procedure. Methods A retrospective chart review was conducted for 37 patients who underwent laparoscopic liver resections for various indications between January 2014 and July 2017 by a single surgeon who had performed 161 open liver resections and 50 live donor hepatectomies during the same period. Results Of 37 laparoscopic liver resections performed, male to female ratio was 23 to 4. Their mean age was 61.4 years. There were 13 cases of wedge resections, 7 cases of left lateral sectionectomy, 9 cases of left hepatectomy, and 8 cases of right hepatectomy. Pathology included hepatocellular carcinoma (n=20), cholangiocarcinoma (n=3), intrahepatic duct stones (n=6), metastatic liver carcinoma (n=6), primary neuroendocrine tumor of liver (n=1), and huge hemangioma (n=1). The mean operation time was 174.7 minutes (range, 40–410 minutes). Mean blood loss was 200.5 ml (range, 10–2200 ml). There were no open-conversion cases. There were no intraoperative or postoperative complications except that a case of severe portal vein stenosis in the laparoscopic right hepatectomy occurred postoperatively. The patient underwent reoperation (portal vein resection and anastomosis, stenting). The mean hospital stay was 8.7 days (range, 2–44 days). Conclusions Even though our experience in laparoscopic liver resection is still developing, our results are comparable to those of other studies. Therefore, an experienced surgeon in performing open liver resection should be able to perform the laparoscopic liver resection safely.

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“…In addition, she emphasized that laparoscopic surgery must be performed using essentially the same principles applied in the open procedure. 24 25 26 27 28 Moreover, she discussed their recent study, which assessed the feasibility of LRH in a large cohort of HCC patients with liver cirrhosis. 29 She stated that even in patients with cirrhosis, pure LRH is not less safe than the traditional open approach, and the oncological outcomes were also comparable.…”

Section: The 3 Rd Expert Forum Of Asia-pacific Lapmentioning

confidence: 99%

Highlights of the Third Expert Forum of Asia-Pacific Laparoscopic Hepatectomy; Endoscopic and Laparoscopic Surgeons of Asia (ELSA) Visionary Summit 2017

Park

Kim

et al. 2018

Ann Hepatobiliary Pancreat Surg

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The application of laparoscopy for liver surgery is rapidly increasing and the past few years have demonstrated a shift in paradigm with a trend towards more extended and complex resections. The development of instruments and technical refinements with the effective use of magnified caudal laparoscopic views have contributed to the ability to overcome the limitation of laparoscopic liver resection. The Endoscopic and Laparoscopic Surgeons of Asia (ELSA) Visionary Summit 2017 and the 3rd Expert Forum of Asia-Pacific Laparoscopic Hepatectomy organized hepatobiliary pancreatic sessions in order to exchange surgical tips and tricks and discuss the current status and future perspectives of laparoscopic hepatectomy. This report summarizes the oral presentations given at the 3rd Expert Forum of Asia-Pacific Laparoscopic Hepatectomy.

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Surgical outcomes following laparoscopic major hepatectomy for various liver diseases

Cited by 20 publications

References 37 publications

Surgical outcomes of laparoscopic versus open liver resection for hepatocellular carcinoma for various resection extent

Surgical outcomes of laparoscopic versus open liver resection for hepatocellular carcinoma for various resection extent

Early experience of laparoscopic liver resection: A single institution experience with 37 consecutive cases

Highlights of the Third Expert Forum of Asia-Pacific Laparoscopic Hepatectomy; Endoscopic and Laparoscopic Surgeons of Asia (ELSA) Visionary Summit 2017

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