World Journal of Surgery

, Volume 37, Issue 4, pp 806–811

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

  • Xuedong Wang
  • Jianwei Li
  • Hongguang Wang
  • Ying Luo
  • Wenbin Ji
  • Weidong Duan
  • Xuan Zhang
  • Sen Guo
  • Kesen Xu
  • Jiahong Dong
  • Shuguo Zheng
Article

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.

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Copyright information

© Société Internationale de Chirurgie 2013

Authors and Affiliations

  • Xuedong Wang
    • 1
  • Jianwei Li
    • 2
  • Hongguang Wang
    • 3
  • Ying Luo
    • 3
  • Wenbin Ji
    • 3
  • Weidong Duan
    • 3
  • Xuan Zhang
    • 3
  • Sen Guo
    • 1
  • Kesen Xu
    • 1
  • Jiahong Dong
    • 1
    • 3
  • Shuguo Zheng
    • 2
  1. 1.Department of Hepatobiliary SurgeryQilu Hospital of Shandong UniversityJinanChina
  2. 2.Department of Hepatobiliary SurgerySouthwest HospitalChongqingChina
  3. 3.Department of Hepatobiliary SurgeryChinese General PLA HospitalBeijingChina

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