Article

World Journal of Surgery

, Volume 37, Issue 4, pp 806-811

First online:

Validation of the Laparoscopically Stapled Approach as a Standard Technique for Left Lateral Segment Liver Resection

  • Xuedong WangAffiliated withDepartment of Hepatobiliary Surgery, Qilu Hospital of Shandong University
  • , Jianwei LiAffiliated withDepartment of Hepatobiliary Surgery, Southwest Hospital
  • , Hongguang WangAffiliated withDepartment of Hepatobiliary Surgery, Chinese General PLA Hospital
  • , Ying LuoAffiliated withDepartment of Hepatobiliary Surgery, Chinese General PLA Hospital
  • , Wenbin JiAffiliated withDepartment of Hepatobiliary Surgery, Chinese General PLA Hospital
  • , Weidong DuanAffiliated withDepartment of Hepatobiliary Surgery, Chinese General PLA Hospital
  • , Xuan ZhangAffiliated withDepartment of Hepatobiliary Surgery, Chinese General PLA Hospital
  • , Sen GuoAffiliated withDepartment of Hepatobiliary Surgery, Qilu Hospital of Shandong University
  • , Kesen XuAffiliated withDepartment of Hepatobiliary Surgery, Qilu Hospital of Shandong University
    • , Jiahong DongAffiliated withDepartment of Hepatobiliary Surgery, Qilu Hospital of Shandong UniversityDepartment of Hepatobiliary Surgery, Chinese General PLA Hospital Email author 
    • , Shuguo ZhengAffiliated withDepartment of Hepatobiliary Surgery, Southwest Hospital

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Abstract

Background

Left lateral sectionectomy (LLS) is the most common type of anatomic laparoscopic liver resection performed, accounting for 20 % of all laparoscopic hepatectomies. Because there has been no standardized surgical technique for laparoscopic left lateral sectionectomy (LLLS), we offer an established operation: laparoscopically stapled left lateral sectionectomy (LSLLS). Our aim was to perform a case-controlled study of LSLLS with traditional (without vascular staplers) laparoscopic left lateral sectionectomy (TLLLS), validating the standardization and reproducibility of LSLLS.

Methods

From February 2009 to December 2011, a total of 49 LSLLSs were performed. The results were compared with 33 cohort-matched TLLLSs from an earlier time period. Ordered sample cluster analysis was used to determine the learning curve of LSLLS based on the operating time and blood loss.

Results

All LSLLS were performed successfully. There were no conversions to laparotomy or hand-assisted laparoscopic resection. Two endoscopic linear staplers were used in each case. Despite a higher hospital cost ($10,892 ± $944 vs. $8,962 ± $943, p < 0.05), LSLLS compared favorably with TLLLS regarding operating time (103 ± 21 vs. 151 ± 32 min, p < 0.05) and blood loss (70.8 ± 41.6 vs. 173.3 ± 131.1 ml, p < 0.05). No specific complications related to laparoscopy were observed. Ordered sample cluster analysis demonstrated a learning curve of 18 cases for LSLLS.

Conclusions

This study demonstrates the standardization and reproducibility of LSLLS. We therefore propose LSLLS as the standard technique for lesions located in the left lateral section of the liver.