Journal of Gastrointestinal Surgery

, Volume 12, Issue 3, pp 457–462

A Prospective Evaluation of Laparoscopic Versus Open Left Lateral Hepatic Sectionectomy

Authors

    • Department of Surgery—Liver UnitScientific Institute San Raffaele, Vita-Salute San Raffaele University
  • Carlo Pulitanò
    • Department of Surgery—Liver UnitScientific Institute San Raffaele, Vita-Salute San Raffaele University
  • Marco Catena
    • Department of Surgery—Liver UnitScientific Institute San Raffaele, Vita-Salute San Raffaele University
  • Marcella Arru
    • Department of Surgery—Liver UnitScientific Institute San Raffaele, Vita-Salute San Raffaele University
  • Eleonora Guzzetti
    • Department of Surgery—Liver UnitScientific Institute San Raffaele, Vita-Salute San Raffaele University
  • Massimiliano Casati
    • Department of Surgery—Liver UnitScientific Institute San Raffaele, Vita-Salute San Raffaele University
  • Laura Comotti
    • Department of AnesthesiologyScientific Institute San Raffaele, Vita-Salute San Raffaele University
  • Gianfranco Ferla
    • Department of Surgery—Liver UnitScientific Institute San Raffaele, Vita-Salute San Raffaele University
Article

DOI: 10.1007/s11605-007-0244-6

Cite this article as:
Aldrighetti, L., Pulitanò, C., Catena, M. et al. J Gastrointest Surg (2008) 12: 457. doi:10.1007/s11605-007-0244-6

Abstract

Background

Left lateral sectionectomy is one of the most commonly performed laparoscopic liver resections, but limited clinical data are actually available to support the advantage of laparoscopic versus open-liver surgery. The present study compared the short-term outcomes of laparoscopic versus open surgery in a case-matched analysis.

Materials and Methods

Surgical outcome of 20 patients who underwent left lateral sectionectomy by laparoscopic approach (LHR group) from September 2005 to January 2007 were compared in a case-control analysis with those of 20 patients who underwent open left lateral sectionectomy (OHR group). Both groups were similar for: tumor size, preoperative laboratory data, presence of cirrhosis, and histology of the lesion. Surgical procedures were performed in both groups combining the ultrasonic dissector and the ultrasonic coagulating cutter without portal clamping.

Results

Compared with OHR, the LHR group had a decreased blood loss (165 mL versus 214 mL, P = 0.001), and earlier postoperative recovery (4.5 versus 5.8 days, P = 0.003). There were no significant differences in terms of surgical margin and operative time. Morbidity was comparable between the two groups, but two cases of postoperative ascites were recorded in two cirrhotic patients in the OHR. Major complications were not observed in either groups.

Conclusions

Laparoscopic resection results in reduced operative blood loss and earlier recovery with oncologic clearance and operative time comparable with open surgery. Laparoscopic liver surgery may be considered the approach of choice for tumors located in the left hepatic lobe.

Keywords

Liver surgeryLaparoscopic liver resectionUltrasonic dissectorUltrasonic coagulating cutter

Copyright information

© The Society for Surgery of the Alimentary Tract 2007