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Laparoscopic Liver Resection: Experience of 436 Cases in One Center

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

To report experience of laparoscopic liver resection (LLR) in one center.

Methods

We retrospectively reviewed 436 consecutive LLRs in 411 patients between December 2010 and December 2016. On the basis of the 2008 Louisville Statement, we divided the 436 cases into two groups: Simple Group (n = 203) and Difficult Group (n = 233).

Results

The indications were HCC (n = 194), colorectal cancer liver metastasis (n = 156), benign tumors (n = 62), hepatolithiasis (n = 2), and other malignant lesions (n = 22). The median tumor size was 24 mm (range 3 to 130). Procedures of LLR included wedge resection (n = 230), one segmentectomy (n = 8), two segmentectomies (n = 12), left lateral sectionectomy (n = 75), right hepatectomy (n = 52), left hepatectomy (n = 31), extended right hepatectomy (n = 2), extended left hepatectomy (n = 5), central bisectionectomy (n = 3), right posterior sectionectomy (n = 12), and right anterior sectionectomy (n = 6). The median operative time was 228 min (range 9–843) and median blood loss was 150 ml (range 2–3500). Twenty-five cases required blood transfusion (5.7%). Conversion to open surgery was required in six cases (1.4%). The mean length of stay was 6.4 ± 2.9 days. Overall complication rate was 9.4% and major complication rate was 5%. One patient died of liver failure on the thirtieth postoperative day after a right hepatectomy. We had higher median blood loss (200 vs. 100 ml; p < 0.001), higher transfusion rate (8.2 vs. 2.9%; p = 0.020), longer median operative time (297 vs. 164 min; p < 0.001), higher conversion rate (2.6 vs. 0%; p = 0.021), higher complication rate (14.2 vs. 3.9%; p < 0.001), and longer mean postoperative hospital stay (6.8 ± 2.9 vs. 5.9 ± 3.0 days; p < 0.001) in the Difficult Group.

Conclusions

Laparoscopic liver resection is safe for selected patients in the Difficult Group. On the basis of the 2008 Louisville Statement, selection criteria of LLR are helpful to predict the difficulty of the operation and the postoperative outcomes of LLR.

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Authors and Affiliations

  1. School of Medicine, China Medical University, No.2, Yude Rd., North Dist, Taichung City, 404, Taiwan

    Te-Hung Chen, Horng-Ren Yang, Long-Bin Jeng, Shih-Chao Hsu, Chia-Hao Hsu, Chun-Chieh Yeh, Mei-Due Yang & William Tzu-Liang Chen

  2. Department of Surgery, China Medical University Hospital, China Medical University, Taichung, Taiwan

    Te-Hung Chen, Horng-Ren Yang, Long-Bin Jeng, Shih-Chao Hsu, Chia-Hao Hsu, Chun-Chieh Yeh, Mei-Due Yang & William Tzu-Liang Chen

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  1. Te-Hung Chen
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Contributions

Te-Hung Chen was involved in study concept and design, data acquisition, analysis, interpretation, and manuscript drafting.

Horng-Ren Yang was involved in study concept and design, data acquisition, analysis, interpretation, and manuscript drafting.

Long-Bin Jeng was involved in study concept and design and data interpretation.

Shih-Chao Hsu was involved in study concept and design and data acquisition.

Chia-Hao Hsu was involved in study concept and design and data acquisition.

Chun-Chieh Yeh was involved in study concept and design and data acquisition.

Mei-Due Yang was involved in study concept and design and data acquisition.

William Tzu-Liang Chen was involved in study concept and design and data interpretation.

Corresponding author

Correspondence to Long-Bin Jeng.

Ethics declarations

This study was approved by the Institutional Review Board of China Medical University Hospital (CMUH107-REC3-077).

Conflict of Interest

The authors declare that they have no conflict of interest.

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Chen, TH., Yang, HR., Jeng, LB. et al. Laparoscopic Liver Resection: Experience of 436 Cases in One Center. J Gastrointest Surg 23, 1949–1956 (2019). https://doi.org/10.1007/s11605-018-4023-3

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  • DOI: https://doi.org/10.1007/s11605-018-4023-3

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