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Modified laparoscopic hepatectomy for hepatic hemangioma

Surgical Endoscopy volume 29, pages 3414–3421 (2015)Cite this article

Abstract

Background

Laparoscopic hepatectomy (LH) using many different surgical techniques has become increasingly popular for the management of hepatic tumors. The performance of surgical procedures involving the least possible impairment is expected increasingly more often by both surgeons and patients. We herein describe a clinical cohort of ten patients with hepatic cavernous hemangioma (HCH) who underwent modified LH (MLH) with a new technique. We herein present the advantages of the low level of impairment during performance of this modified procedure and compare the outcomes of MLH with those of traditional LH (TLH) for HCH.

Methods

We retrospectively evaluated the treatment outcomes in 24 patients with HCH who underwent MLH (n = 10) or TLH (n = 14) from February 2008 to January 2013. Their demographic, intraoperative, and postoperative variables were compared.

Results

MLH was successful in all patients. An electromechanical morcellator allowed for easy extraction of the entire HCH without the use of a cumbersome retrieval bag, enlarged incision, or hand-assisted incision. There was no conversion to an open operation or significant perioperative complications. The operation time (P = 0.037), time to removal of the HCH (P < 0.0001), visual analog scale pain score on the first postoperative day (P = 0.012), time to off-bed activity (P = 0.036), and postoperative hospital stay (P = 0.048) were significantly lower in the MLH group than in the TLH group.

Conclusions

MLH involving the use of an electromechanical morcellator provides expedient recovery and minimal postoperative pain and scarring. It is a feasible, effective, and safe surgical procedure and embodies all of the benefits of minimally invasive surgery for patients with HCH.

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Disclosures

D.-S. Bai, P. Chen, J.-J. Qian, J. Yao, S.-J. Jin, X.-D. Wang, and G.-Q. Jiang have no conflicts of interest or financial ties to disclose.

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    Affiliations

    1. Department of Hepatobiliary Surgery, Clinical Medical College of Yangzhou University, 98 West Nantong Rd, Yangzhou, 225000, China

      Dou-Sheng Bai, Ping Chen, Jian-Jun Qian, Jie Yao, Sheng-Jie Jin, Xiao-Dong Wang & Guo-Qing Jiang

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    1. Dou-Sheng Bai
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    2. Ping Chen
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    3. Jian-Jun Qian
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    7. Guo-Qing Jiang
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    Correspondence to Guo-Qing Jiang.

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    Dou-Sheng Bai, Ping Chen, and Jian-Jun Qian contributed equally to this work.

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    Bai, DS., Chen, P., Qian, JJ. et al. Modified laparoscopic hepatectomy for hepatic hemangioma. Surg Endosc 29, 3414–3421 (2015). https://doi.org/10.1007/s00464-014-4048-y

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    Keywords

    • Laparoscopy
    • Hepatectomy
    • Hemangioma
    • Morcellator