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Laparoscopic left liver resections: how far can we go?

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Abstract

Introduction

The aim of this study was to analyse the outcomes of laparoscopic anatomic hepatectomies of the left liver segments.

Methods

This is a retrospective multicentre study including all patients operated on laparoscopically divided into unisegmentectomy of 2, 3 or 4 (Group 1), left lobectomy (or left lateral sectionectomy LLS) (Group 2), left hepatectomy (Group 3) and extended left hepatectomy (Group 4) between 2000 and 2016. These four groups were compared in terms of demographics, intraoperative data and postoperative outcomes.

Results

Among the 190 selected patients, the groups 1, 2, 3, 4 included 25 (13.2%), 116 (61.0%), 27 (14.2%) and 22 (11.6%) patients, respectively. The cohorts were comparable except for the number of lesions (p = 0.001) and tumour diameter (p = 0.004). The operative time, blood loss and the use of vascular clamping were more frequent in the Groups 3 and 4 (p = 0.0001), as is the rate of conversion to laparotomy (p = 0.001). Total morbidity was 23.3%, and major complications were more frequent in Group 4 (p = 0.0001). The prevalence of hepatic complications (11.6%), intra-abdominal collections (7.4%) and respiratory complications (3.7%) was proportionally correlated to the hepatectomy extension (p = 0.0001).

Conclusion

All laparoscopic left liver resections seem safe and feasible even though extended hepatectomy is associated with a significant morbidity.

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Abbreviations

LLR:

Laparoscopic liver resection

LLS:

Laparoscopic left sectionectomy

LMH:

Laparoscopic major hepatectomy

CRLM:

Colorectal liver metastases

HCC:

Hepatocellular carcinoma

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Authors and Affiliations

  1. Department of Digestive Disease, Institut Mutualiste Montsouris, Université Paris Descartes, 42 Boulevard Jourdan, 75014, Paris, France

    Giada Pattaro, David Fuks, Hadrien Tranchart, Amal Suhool, Christophe Bourdeaux, Panagiotis Lainas, Ibrahim Dagher & Brice Gayet

  2. Department of General Surgery and Tansplantation, Polo Ospedaliero Interaziendale Trapianti “San Camillo-Forlanini” IRCSS-INMI “L. Spallanzani”, Rome, Italy

    Giada Pattaro & Giuseppe Maria Ettorre

  3. Department of Minimally Invasive Digestive Surgery, Hôpital Antoine Béclère, Université Paris Sud, Paris, France

    Giada Pattaro, David Fuks, Hadrien Tranchart, Panagiotis Lainas, Ibrahim Dagher & Brice Gayet

Authors
  1. Giada Pattaro
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  2. David Fuks
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  3. Hadrien Tranchart
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  4. Giuseppe Maria Ettorre
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  5. Amal Suhool
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  6. Christophe Bourdeaux
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  7. Panagiotis Lainas
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  8. Ibrahim Dagher
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  9. Brice Gayet
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Corresponding author

Correspondence to David Fuks.

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Disclosures

Giada Pattaro, David Fuks, Hadrien Tranchart, GM Ettorre, Amal Suhool, Christophe Bourdeaux, Panagiotis Lainas, Ibrahim Dagher, and Brice Gayet have no conflicts of interest or financial ties to disclose.

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Pattaro, G., Fuks, D., Tranchart, H. et al. Laparoscopic left liver resections: how far can we go?. Surg Endosc 31, 5303–5311 (2017). https://doi.org/10.1007/s00464-017-5606-x

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  • DOI: https://doi.org/10.1007/s00464-017-5606-x

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