LAPAROSCOPIC LIVER RESECTION FOR LOCALIZED PRIMARY INTRAHEPATIC BILE DUCT DILATATION
Ibrahim DAGHER, Papa Saloum DIOP, Alessio CARLONI, Panagiotis LAINAS, Dominique FRANCO
Department of General Surgery, Antoine Béclère Hospital, AP-HP, Clamart, F-92140, France; Univ Paris-Sud, Orsay, F-91405, France.
Objective of the study: Primary intrahepatic bile duct dilatation (IHBD) may present as a localized form, in which resection of the affected liver can prevent immediate and late complications. Laparoscopy has gained large interest in liver surgery. It also allows a safe and efficient exploration of the common bile duct. We present here our results concerning the feasibility and safety of anatomical laparoscopic liver resection for localized IHBD.
Methods and procedures: We performed 10 laparoscopic liver resections for localized IHBD, on seven women and three men (mean age: 47 ± 5 years). Resections were: two right hepatectomies, three left hepatectomies and five left lateral sectionectomies. Three patients had associated common bile duct stones which were treated through perioperative cholangioscopy. The data collected included: age, sex, localization of disease, type of liver resection, duration of surgery, blood loss, perioperative transfusions, conversion to open surgery, postoperative complications, and length of hospital stay. Values were expressed as means ± SEM.
Results: Mean operative time was 303.9 ± 36 min. Mean blood loss was 217.5 ± 84 ml. None of these patients required hand assistance or conversion to open surgery. One patient suffered a residual collection which was drained percutaneously. Postoperative course was uneventful in the other patients. Mean hospital stay was 5.3 ± 0.8 days. No recurrence of cholangitis was observed after a mean follow-up of 45.6 months.
Conclusions based on the results: The laparoscopic treatment of IHBD combines two specialized procedures requiring knowledge and technical skill in both hepatobiliary surgery and laparoscopy. This procedure is safe and should be performed by teams with expertise in these two areas of surgery.
Program Number: P432