An initial experience and evolution of laparoscopic hepatic resectional surgery

TitleAn initial experience and evolution of laparoscopic hepatic resectional surgery
Publication TypeJournal Article
Year of Publication2004
AuthorsBuell JF, Thomas MJ, Doty TC, Gersin KS, Merchen TD, Gupta M, Rudich SM, Woodle ES
Pagination804 - 11
Date PublishedOct
Accession Number15467665
KeywordsAdult, Aged, Aged, 80 and over, Female, Hepatectomy / *methods, Humans, Laparoscopy / *methods, Liver Diseases / *surgery, Liver Neoplasms / surgery, Male, Middle Aged, Patient Selection, Treatment Outcome

BACKGROUND: The use of minimally invasive procedures has revolutionized modern surgery. Only recently has laparoscopy been introduced for use in hepatic surgery. METHODS: Patient demographics, tumor characteristics, and outcomes were evaluated for all initial cases of laparoscopic hepatic resection. RESULTS: Twenty-one resections were performed in 17 patients; 5 were performed for malignancy, of which 3 had underlying cirrhosis, and the remaining 12 for benign symptomatic disease. Mean patient age was 55.4 (range, 24-82 years). The mean number of lesions was 1.4 (range, 1-5), having an average size of 7.6 cm (range, 2-30 cm). Mean operative time was 2.8 hours (range, 2-5 hours) hours. Most resections involved 1 or more Couinaud segments. Mean blood loss was 288 cc (range, 50-150 cc). Complications included re-operation for hemorrhage (n=2), biliary leakage (n=1), and death from hepatic failure (n=1). Mean length of stay was 2.9 days (range, 1-14). When compared with our series of 100 patients who underwent open hepatic resection for benign tumors, significantly greater means ( P <.05 were="" noted="" for="" blood="" loss="" cc="" operative="" time="" hours="" and="" length="" of="" stay="" days="" conclusions:="" laparoscopic="" hepatic="" surgery="" though="" complex="" can="" be="" performed="" safely="" efficaciously.="" minimally="" invasive="" appears="" to="" provide="" several="" distinct="" advantages="" over="" traditional="" open="" surgery.="" however="" techniques="" the="" control="" bleeding="" bile="" leak="" remain="" in="" their="" infancy.="">

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