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Surgical Endoscopy

, Volume 33, Issue 1, pp 261–271 | Cite as

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

  • Lionel Rebibo
  • Pauline Leourier
  • Rachid Badaoui
  • Fabien Le Roux
  • Emmanuel Lorne
  • Jean-Marc RegimbeauEmail author
Article
  • 124 Downloads

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.

Keywords

Laparoscopic liver resection Day-case surgery Outpatient surgery Ambulatory surgery 

Abbreviations

DCS

Day-case surgery

LLR

Laparoscopic liver resection

Notes

Compliance with ethical standards

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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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Lionel Rebibo
    • 1
  • Pauline Leourier
    • 1
  • Rachid Badaoui
    • 2
  • Fabien Le Roux
    • 1
  • Emmanuel Lorne
    • 2
    • 3
  • Jean-Marc Regimbeau
    • 1
    • 3
    • 4
    Email author
  1. 1.Department of Digestive SurgeryAmiens University HospitalAmiens Cedex 01France
  2. 2.Department of AnaesthesiologyAmiens University HospitalAmiens Cedex 01France
  3. 3.SSPC (Simplification des Soins des Patients Complexes) - Clinical Research UnitUniversity of Picardie Jules VerneAmiens Cedex 01France
  4. 4.Service de chirurgie digestive, Hôpital Sud, CHU d’AmiensAmiens Cedex 01France

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