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Feasibility of laparoscopic liver resection for caudate lobe: technical strategy and comparative analysis with anteroinferior and posterosuperior segments

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Abstract

Background

Although laparoscopic liver resection (LLR) is now considered a standard procedure in peripheral segments, there are few reports on laparoscopic segment 1 (Sg1) resection. The aim of this study was to assess both safety and feasibility of Sg1 LLR.

Methods

From 2000 to 2014, all patients who underwent LLR were identified from a prospective database. Patients with resection of Sg1 (Sg1 group) were compared with those with resection of anteroinferior segments (AI group: segments 3, 4b, 5, 6) or posterosuperior segments (PS group: segments 4a, 7, 8), in terms of tumor characteristics, surgical treatment, and short-term outcomes.

Results

There were 15, 151, and 67 patients in Sg1, AI, and PS groups. Tumor size and tumor number were similar between the three groups (p = 0.139, p = 0.102). Operative time was significantly shorter in Sg1 (150 min) and AI group (135 min) compared with PS group (180 min) (p = 0.021). Median blood loss was notably higher in PS group (140 ml) compared with Sg1 group (75 ml) and AI group (10 ml) (p = 0.001). No mortality was observed in all groups. Postoperative complication rate was 20.0 % with Sg1 group, 14.6 % with AI group, and 20.9 % with PS group (p = 0.060). The rate of major complication was significantly higher in Sg1 group (13.3 %) and PS group (11.9 %) compared with AI group (4.0 %) (p = 0.042). Resection margins were clear in all Sg1 and PS group patients, whereas two (1.3 %) patients in AI group had R1 margins (p = 0.586).

Conclusion

The laparoscopic approach of isolated resection located in the caudate lobe is a feasible and curative surgical option in selected patients.

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Acknowledgments

We thank Dr. Mahendran Govindasamy for coordinating patient’s follow-up and maintaining the prospective database that formed the basis of this study.

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Authors and Affiliations

  1. Department of Digestive Diseases, Institut Mutualiste Montsouris, Paris Descartes University, 42 Boulevard Jourdan, 75014, Paris, France

    Kenichiro Araki, David Fuks, Takeo Nomi, Satoshi Ogiso, Ruben R. Lozano & Brice Gayet

  2. Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan

    Kenichiro Araki & Hiroyuki Kuwano

  3. Department of Surgery, Nara Medical University, Nara, Japan

    Takeo Nomi

  4. Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Satoshi Ogiso

Authors
  1. Kenichiro Araki
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  2. David Fuks
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  3. Takeo Nomi
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  4. Satoshi Ogiso
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  5. Ruben R. Lozano
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  6. Hiroyuki Kuwano
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  7. Brice Gayet
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Corresponding author

Correspondence to Brice Gayet.

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Disclosures

Kenichiro Araki, David Fuks, Takeo Nomi, Satoshi Ogiso, Ruben R Lozano, Hiroyuki Kuwano, and Brice Gayet have no conflict of interest. Brice Gayet is consultant for Olympus.

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Araki, K., Fuks, D., Nomi, T. et al. Feasibility of laparoscopic liver resection for caudate lobe: technical strategy and comparative analysis with anteroinferior and posterosuperior segments. Surg Endosc 30, 4300–4306 (2016). https://doi.org/10.1007/s00464-016-4747-7

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  • DOI: https://doi.org/10.1007/s00464-016-4747-7

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