Laparoscopic Liver Resection with Prior Vascular Control

INTRODUCTION: The magnification of laparoscopy allows a very precise dissection of the portal pedicles. The aim of this study was to evaluate the effect of prior vascular control (PVC) on parenchymal dissection in 105 consecutive patients undergoing laparoscopic liver resections.
METHODS: Between 1999 and 2006 we have performed 105 laparoscopic liver resections. Portal vessels and the hepatic vein were controlled and divided before parenchymal transection, only in formal anatomic resections. Operative duration, blood loss, conversion rates and postoperative complications were compared with patients undergoing laparoscopic non anatomic resections without PVC.
RESULTS: We studied 49 laparoscopic liver resections with PVC and 56 without PVC. There were 25 major resections (>3 segments) in the PVC group and only 3 in the group without PVC. There was no difference in operative time between the two groups (244 ± 113 in the PVC group vs. 218 ± 119 minutes without PVC, p=ns). Seven patients underwent conversion, only one in the group with PVC and 6 in the group without PVC. Blood loss and transfusion rate were lower in the group with PVC (201 vs. 543 ml, p

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Program Number: P333

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