Totally laparoscopic liver resection: new brazilian experience

Abstract

BackgroundDespite the increasing number of laparoscopic hepatectomy, there is little published experience.AimTo evaluate the results of a series of hepatectomy completely done with laparoscopic approach.MethodsThis is a retrospective study of 61 laparoscopic liver resections. Were studied conversion to open technique; mean age; gender, mortality; complications; type of hepatectomy; surgical techniques applied; and simultaneous operations.ResultsThe conversion to open technique was necessary in one case (1.6%). The mean age was 54.7 years (17-84), 34 were men. Three patients (4.9%) had complications. One died postoperatively (mortality 1.6%) and no deaths occurred intraoperatively. The most frequent type was right hepatectomy (37.7%), followed by bisegmentectomy (segments II-III and VI-VII). Were not used hemi-Pringle maneuvers or assisted technic. Six patients (8.1%) underwent simultaneous procedures (hepatectomy and colectomy).ConclusionLaparoscopic hepatectomy is feasible procedure and can be considered the gold standard for various conditions requiring liver resections for both benign to malignant diseases.

Immediate Complications After 88 Hepatectomies - Brazilian Consecutive Series

“…It is believed that there were three possible main reasons for the improved results. Firstly, the second half of the sample showed greater tendency to minor hepatectomies and followed the trend in the literature of saving the maximum amount of liver parenchyma as possible 15 . Secondly, there was less need of transfusion, less perioperative bleeding and less incidence of postoperative intraperitoneal collections, probably due to the ultrasonic surgical aspirator used to section the parenchyma in the second half of the series.…”

Laparoscopic hepatectomy for benign hepatic lesions: short and long-term outcomes including quality-of-life evaluation

“…Major hepatectomy was defined as resection of three or more hepatic segments. The surgical techniques used for LH were either the intra-hepatic Glissonian approach [ Figures 1 and 2] or the extra-hepatic Glissonian approach [ Figures 3 and 4], in accordance with previous standardization [7,[11][12][13] . Intraoperative ultrasonography was performed whenever available.…”

“…Therefore, laparoscopic left lateral sectionectomy has been one of the most performed types of LH along the learning curve of many authors [8,10,12] . Even though laparoscopic left lateral sectionectomy and right posterior sectionectomy were the most frequent LHs performed in the present series, more complex LHs including left hepatectomy, right hepatectomy and even mesohepatectomy were also performed, reflecting the strong trend in the literature towards performing more complex procedures for treating hepatic lesions [2][3][4][5][6][7][8][9][10][11][12][13]15,23] .…”

“…Many studies, including meta-analyses, have confirmed the benefits of LH in comparison with open hepatectomy, namely: lower levels of postoperative pain, fewer peritoneal adhesions, shorter hospital stay, earlier return to daily activities, lower blood loss, reduced morbidity, fewer operative complications and less mortality [2][3][4][5][6][7][8][9][10][11][12][13][14][15][18][19][20][21][22][23][24][25][26][27][28][29] . Among the short-term outcomes from our study, a low blood loss (mean 125 mL), short hospital stay, low morbidity (6.4%) and no mortality are clearly in accordance with the many advantages reported in previous studies.…”

“…Even though LH has been shown to be both safe and effective; the restricted indications for resection in the case of benign liver lesions have resulted in poorly reported longterm outcomes. In addition, there is a need to know whether LH might improve the overall postoperative quality of life (QoL) of patients with benign lesions [8][9][10][11][12][13][14][15] .…”