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Laparoscopic left hemihepatectomy: a safety and feasibility study of 19 cases

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Abstract

Background

Laparoscopic liver resection was performed at some institutes. The procedure mainly included local resection, segmentectomy, and left lateral segmentectomy. With experience accumulation and technique innovation, laparoscopic left hemihepatectomy was performed in selected patients. This study was designed to introduce and evaluate the safety and feasibility of this procedure.

Methods

Nineteen successive patients underwent laparoscopic left hemihepatectomy from 2005 to 2007. They were compared by the matched-pair method with 19 other patients who underwent conventional open left hemihepatectomy. Surgical feature, postoperative course, and the learning curve of laparoscopic left hemihepatectomy were studied.

Results

Laparoscopic hemihepatectomy was successfully performed in 17 cases. Two conversions were required. Compared with the open group, the blood loss was significantly less in the laparoscopic group (462 ± 372 vs. 895 ± 704, p = 0.03). Postoperative hospital stay of the laparoscopic group was shorter but not significant compared with the open group (9 ± 5 vs. 13 ± 7, p = 0.086). Postoperative albumin level in the laparoscopic group was significantly higher than the open group (33 ± 4.8 vs. 27.6 ± 3.2, p = 0.001). There was no perioperative mortality in either group. Two complications occurred in the laparoscopic group (11%) and four in the open group (21%). A tendency of gradually decreased transecting time was noticed in the early cases (R2 = 0.676; p = 0.012).

Conclusions

Laparoscopic left hemihepatectomy is a safe and feasible procedure for select patients.

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Acknowledgement

Supported by Foundation of Science and Technology Department of Zhejiang Province, No. 2003C33055.

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Authors and Affiliations

  1. Institute of Minimally Invasive Surgery, Zhejiang University, Hangzhou, 310016, China

    Xiu-Jun Cai, Yi-Fan Wang, Yue-Long Liang, Hong Yu & Xiao Liang

  2. Department of General Surgery, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, No. 3, East Qinchun Road, Hangzhou, 310016, China

    Xiu-Jun Cai, Yi-Fan Wang, Yue-Long Liang, Hong Yu & Xiao Liang

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  1. Xiu-Jun Cai
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  2. Yi-Fan Wang
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Correspondence to Xiu-Jun Cai.

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Cai, XJ., Wang, YF., Liang, YL. et al. Laparoscopic left hemihepatectomy: a safety and feasibility study of 19 cases. Surg Endosc 23, 2556–2562 (2009). https://doi.org/10.1007/s00464-009-0454-y

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  • DOI: https://doi.org/10.1007/s00464-009-0454-y

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