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Evolution of a laparoscopic liver resection program: an analysis of 203 cases

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Abstract

Background

Techniques for laparoscopic liver resection (LLR) have been developed over the past two decades. The aim of this study is to analyze the outcomes and trends of LLR.

Methods

203 patients underwent LLR between 2006 and 2015. Trends in techniques and outcomes were assessed dividing the experience into 2 periods (before and after 2011).

Results

Tumor type was malignant in 62%, and R0 resection was achieved in 87.7%. Procedures included segmentectomy/wedge resection in 64.5%. Techniques included a purely laparoscopic approach in 59.1% and robotic 12.3%. Conversion to open surgery was necessary in 6.4% cases. Mean hospital stay was 3.7 ± 0.2 days. 90-day mortality was 0% and morbidity 20.2%. Pre-coagulation and the robot were used less often, while the performance of resections for posteriorly located tumors increased in the second versus the first period.

Conclusion

This study confirms the safety and efficacy of LLR, while describing the evolution of a program regarding patient and technical selection. With building experience, the number of resections performed for posteriorly located tumors have increased, with less reliance on pre-coagulation and the robot.

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Authors and Affiliations

  1. Department of General Surgery, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, 44195, USA

    Mohammed Elshamy, Hideo Takahashi, Muhammet Akyuz, Pinar Yazici, Hakan Yigitbas, Abdulrahman Y. Hammad, Federico N. Aucejo, Cristiano Quintini, John Fung & Eren Berber

Authors
  1. Mohammed Elshamy
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  2. Hideo Takahashi
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  3. Muhammet Akyuz
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  4. Pinar Yazici
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  5. Hakan Yigitbas
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  6. Abdulrahman Y. Hammad
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  7. Federico N. Aucejo
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  8. Cristiano Quintini
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  9. John Fung
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  10. Eren Berber
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Corresponding author

Correspondence to Eren Berber.

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Disclosures

Eren Berber, MD, is a consultant to Ethicon (Ethicon Inc.; Somerville, NJ) and Aesculap (Aesculap Inc. USA; Center Valley, PA). He received honoraria from Ethicon for these activities. Drs. Elshamy, Takahashi, Akyuz, Yazici, Yigitbas, Hammad, Aucejo, Quintini, Fung have no conflicts of interest or financial ties to disclose.

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Elshamy, M., Takahashi, H., Akyuz, M. et al. Evolution of a laparoscopic liver resection program: an analysis of 203 cases. Surg Endosc 31, 4150–4155 (2017). https://doi.org/10.1007/s00464-017-5468-2

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  • DOI: https://doi.org/10.1007/s00464-017-5468-2

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