Skip to main content

Advertisement

SpringerLink
Log in

A comparison of laparoscopic resection of posterior segments with formal laparoscopic right hepatectomy for colorectal liver metastases: a single-institution study

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Introduction

The benefit of by laparoscopic resection for lesions located in postero-superior segments is unclear. The present series aimed at comparing intraoperative and post-operative results in patients undergoing either laparoscopic RPS or laparoscopic RH for colorectal liver metastases located in the right postero-superior segments.

Methods

From 2000 to 2015, patients who underwent laparoscopic resection of segment 6 and/or 7 (RPS group) were compared with those with right hepatectomy (RH group) in terms of tumour characteristics, surgical treatment, and short-term outcomes.

Results

Among the 177 selected patients, 78 (44.1 %) had laparoscopic RPS and 99 (55.9 %) a laparoscopic RH. Among RPS patients, 26 (33.3 %) underwent anatomical resection of either segment 7, 8 or both. Three (3 %) patients undergoing RH died in the post-operative course and none in the RPS group. Sixty-three (35.5 %) patients experienced post-operative complications, including major complications in 24 (13.5 %) patients. Liver failure (17.1 vs. 0 %, p = 000.1), biliary leakage (6.0 vs. 1.2 %, p = 00.1), intra-abdominal collection (19.1 vs. 2.5 %, p = 000.1), and pulmonary complication (16.1 vs. 1.2 %, p = 000.1) were significantly increased in the RH group.

Conclusion

The present series suggests that patients who underwent laparoscopic resection of CRLM located in the postero-superior segments developed significantly less complications than patients undergoing formal RH.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

ASA:

American Society of Anesthesiology

LLR:

Laparoscopic liver resection

LMH:

Laparoscopic major hepatectomy

PVO:

Portal vein occlusion

CRLM:

Colorectal liver metastases

HCC:

Hepatocellular carcinoma

References

  1. Nguyen KT, Gamblin TC, Geller DA (2009) World review of laparoscopic liver resection-2,804 patients. Ann Surg 250:831–841

    Article  PubMed  Google Scholar 

  2. Jarnagin WR, Gonen M, Fong Y, DeMatteo RP, Ben-Porat L, Little S, Corvera C, Weber S, Blumgart LH (2002) Improvement in perioperative outcome after hepatic resection: analysis of 1,803 consecutive cases over the past decade. Ann Surg 236:397–406 (discussion 406-397)

    Article  PubMed  PubMed Central  Google Scholar 

  3. Belghiti J, Hiramatsu K, Benoist S, Massault P, Sauvanet A, Farges O (2000) Seven hundred forty-seven hepatectomies in the 1990 s: an update to evaluate the actual risk of liver resection. J Am Coll Surg 191:38–46

    Article  CAS  PubMed  Google Scholar 

  4. Buell JF, Cherqui D, Geller DA, O’Rourke N, Iannitti D, Dagher I, Koffron AJ, Thomas M, Gayet B, Han HS, Wakabayashi G, Belli G, Kaneko H, Ker CG, Scatton O, Laurent A, Abdalla EK, Chaudhury P, Dutson E, Gamblin C, D’Angelica M, Nagorney D, Testa G, Labow D, Manas D, Poon RT, Nelson H, Martin R, Clary B, Pinson WC, Martinie J, Vauthey JN, Goldstein R, Roayaie S, Barlet D, Espat J, Abecassis M, Rees M, Fong Y, McMasters KM, Broelsch C, Busuttil R, Belghiti J, Strasberg S, Chari RS, World Consensus Conference on Laparoscopic S (2009) The international position on laparoscopic liver surgery: The Louisville Statement, 2008. Annals of surgery 250, 825–830

  5. Yin Z, Fan X, Ye H, Yin D, Wang J (2013) Short- and long-term outcomes after laparoscopic and open hepatectomy for hepatocellular carcinoma: a global systematic review and meta-analysis. Ann Surg Oncol 20:1203–1215

    Article  PubMed  Google Scholar 

  6. Schiffman SC, Kim KH, Tsung A, Marsh JW, Geller DA (2015) Laparoscopic versus open liver resection for metastatic colorectal cancer: a metaanalysis of 610 patients. Surgery 157:211–222

    Article  PubMed  Google Scholar 

  7. Alkhalili E (2014) Laparoscopic liver resection for malignancy: a review of the literature. World J Gastroenterol 20:13599

    Article  PubMed  PubMed Central  Google Scholar 

  8. Herman P, Kruger J, Lupinacci R, Coelho F, Perini M (2013) Laparoscopic bisegmentectomy 6 and 7 using a Glissonian approach and a half-Pringle maneuver. Surg Endosc 27:1840–1841

    Article  PubMed  Google Scholar 

  9. Koffron AJ, Auffenberg G, Kung R, Abecassis M (2007) Evaluation of 300 minimally invasive liver resections at a single institution: less is more. Ann Surg 246:385–392 (discussion 392-384)

    Article  PubMed  PubMed Central  Google Scholar 

  10. Cho JY, Han HS, Yoon YS, Choi Y, Lee W (2015) Outcomes of laparoscopic right posterior sectionectomy in patients with hepatocellular carcinoma in the era of laparoscopic surgery. Surgery 158:135–141

    Article  PubMed  Google Scholar 

  11. Vigano L, Russolillo N, Ferrero A, Langella S, Sperti E, Capussotti L (2012) Evolution of long-term outcome of liver resection for colorectal metastases: analysis of actual 5-year survival rates over two decades. Ann Surg Oncol 19:2035–2044

    Article  PubMed  Google Scholar 

  12. Topal B, Fieuws S, Aerts R, Vandeweyer H, Penninckx F (2008) Laparoscopic versus open liver resection of hepatic neoplasms: comparative analysis of short-term results. Surg Endosc 22:2208–2213

    Article  CAS  PubMed  Google Scholar 

  13. Wicherts DA, de Haas RJ, Salloum C, Andreani P, Pascal G, Sotirov D, Adam R, Castaing D, Azoulay D (2013) Repeat hepatectomy for recurrent colorectal metastases. Br J Surg 100:808–818

    Article  CAS  PubMed  Google Scholar 

  14. IHPBA TCOT (2000) Terminology of liver anatomy and resections. HPB Surg 2

  15. Fuks D, Gayet B (2015) Laparoscopic surgery of postero-lateral segments: a comparison between transthoracic and abdominal approach. Updates in Surg 67:141–145

    Article  Google Scholar 

  16. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213

    Article  PubMed  PubMed Central  Google Scholar 

  17. Balzan S, Belghiti J, Farges O, Ogata S, Sauvanet A, Delefosse D, Durand F (2005) The “50-50 criteria” on postoperative day 5: an accurate predictor of liver failure and death after hepatectomy. Ann Surg 242:824–828 (discussion 828-829)

    Article  PubMed  PubMed Central  Google Scholar 

  18. Koch M, Garden OJ, Padbury R, Rahbari NN, Adam R, Capussotti L, Fan ST, Yokoyama Y, Crawford M, Makuuchi M, Christophi C, Banting S, Brooke-Smith M, Usatoff V, Nagino M, Maddern G, Hugh TJ, Vauthey JN, Greig P, Rees M, Nimura Y, Figueras J, DeMatteo RP, Buchler MW, Weitz J (2011) Bile leakage after hepatobiliary and pancreatic surgery: a definition and grading of severity by the International Study Group of Liver Surgery. Surgery 149:680–688

    Article  PubMed  Google Scholar 

  19. Fisher SB, Kneuertz PJ, Dodson RM, Patel SH, Maithel SK, Sarmiento JM, Russell MC, Cardona K, Choti MA, Staley CA 3rd, Pawlik TM, Kooby DA (2013) A comparison of right posterior sectorectomy with formal right hepatectomy: a dual-institution study. HPB: Off J Int Hepato Pancreato Biliary Assoc 15:753–762

    Article  Google Scholar 

  20. Hammond JS, Guha IN, Beckingham IJ, Lobo DN (2011) Prediction, prevention and management of postresection liver failure. Br J Surg 98:1188–1200

    Article  CAS  PubMed  Google Scholar 

  21. Nomi T, Fuks D, Ogiso S, Nakajima Y, Louvet C, Gayet B (2016) Second and Third Laparoscopic Liver Resection for Patients With Recurrent Colorectal Liver Metastases. Ann Surg 263:e68–e72

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Digestive Disease, Institut Mutualiste Montsouris, Jourdan, 75014, Paris, France

    Luca Portigliotti, David Fuks, Oleg Slivca, Christophe Bourdeaux, Takeo Nomi & Brice Gayet

  2. Department of Surgery, Università del Piemonte Orientale, Novara, Italy

    Luca Portigliotti & Sergio Gentilli

  3. Université Paris Descartes, 15 rue de l’Ecole de Médecine, Paris, France

    David Fuks & Brice Gayet

  4. Department of Surgical Oncology, Institut Mutualiste Montsouris, Université Paris Descartes, Paris, France

    Mostefa Bennamoun

Authors
  1. Luca Portigliotti
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. David Fuks
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Oleg Slivca
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Christophe Bourdeaux
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Takeo Nomi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mostefa Bennamoun
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sergio Gentilli
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Brice Gayet
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Luca Portigliotti.

Ethics declarations

Disclosure

Luca Portigliotti, David Fuks, Oleg Slivca, Christophe Bourdeaux, Takeo Nomi, Mostefa Bennamoun, Sergio Gentilli, Brice Gayet have no conflicts of interest or financial ties to disclose.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Portigliotti, L., Fuks, D., Slivca, O. et al. A comparison of laparoscopic resection of posterior segments with formal laparoscopic right hepatectomy for colorectal liver metastases: a single-institution study. Surg Endosc 31, 2560–2565 (2017). https://doi.org/10.1007/s00464-016-5261-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-016-5261-7

Keywords

Search

Navigation