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Minor laparoscopic liver resection as day-case surgery (without overnight hospitalisation): a pilot study

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Abstract

Background

Day-case surgery (DCS) has become increasingly popular over recent years, as has laparoscopic liver resection (LLR) for the treatment of benign or malignant liver tumours. The purpose of this prospective study was to demonstrate the feasibility of minor LLR as DCS.

Methods

Prospective, intention-to-treat, non-randomised study of patients undergoing minor LLR between July 2015 and December 2017. Exclusion criteria were resection by laparotomy, major LLR, difficult locations for minor LLR, history of major abdominal surgery, hepatobiliary procedures without liver parenchyma resection, cirrhosis with Child > A and/or portal hypertension, significant medical history and exclusion criteria for DCS. The primary endpoint was the unplanned overnight admission rate. Secondary endpoints were the reason for exclusion, complication data, criteria for DCS evaluation, satisfaction and compliance with the protocol.

Results

One hundred sixty-seven patients underwent liver resection during the study period. LLR was performed in 92 patients (55%), as DCS in 23 patients (25%). Reasons for minor LLR were liver metastasis (n = 9), hepatic adenoma (n = 5), hepatocellular carcinoma (n = 4), ciliated hepatic foregut cyst (n = 2) and other benign tumours (n = 3). All day-case minor LLR, except two patients, consisted of single wedge resection, while one patient underwent left lateral sectionectomy. There were four unplanned overnight admissions (17.4%), one unscheduled consultation (4.3%), two hospital readmissions (8.6%) and no major complications/mortality. Compliance with the protocol was 69.5%. Satisfaction rate was 91%.

Conclusion

In selected patients, day-case minor LLR is feasible with acceptable complication and readmission rates. Day-case minor LLR can therefore be legitimately proposed in selected patients.

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Abbreviations

DCS:

Day-case surgery

LLR:

Laparoscopic liver resection

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Authors and Affiliations

  1. Department of Digestive Surgery, Amiens University Hospital, Avenue René Laennec, 80054, Amiens Cedex 01, France

    Lionel Rebibo, Pauline Leourier, Fabien Le Roux & Jean-Marc Regimbeau

  2. Department of Anaesthesiology, Amiens University Hospital, Avenue René Laennec, 80054, Amiens Cedex 01, France

    Rachid Badaoui & Emmanuel Lorne

  3. SSPC (Simplification des Soins des Patients Complexes) - Clinical Research Unit, University of Picardie Jules Verne, 80054, Amiens Cedex 01, France

    Emmanuel Lorne & Jean-Marc Regimbeau

  4. Service de chirurgie digestive, Hôpital Sud, CHU d’Amiens, Avenue René Laennec, 80054, Amiens Cedex 01, France

    Jean-Marc Regimbeau

Authors
  1. Lionel Rebibo
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  2. Pauline Leourier
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  3. Rachid Badaoui
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  4. Fabien Le Roux
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  5. Emmanuel Lorne
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  6. Jean-Marc Regimbeau
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Correspondence to Jean-Marc Regimbeau.

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Disclosure

Lionel Rebibo, Pauline Leourier, Rachid Badaoui, Fabien Le Roux, Emmanuel Lorne and Jean-Marc Regimbeau have no conflicts of interest or financial ties to disclose.

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Rebibo, L., Leourier, P., Badaoui, R. et al. Minor laparoscopic liver resection as day-case surgery (without overnight hospitalisation): a pilot study. Surg Endosc 33, 261–271 (2019). https://doi.org/10.1007/s00464-018-6306-x

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  • DOI: https://doi.org/10.1007/s00464-018-6306-x

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