Fesibility of Two-stage Laparoscopic Hepatectomy for Bilobar Metastatic Liver Tumors.

Hitoshi Inagaki, MD. Gifu Chuo Hospital, Japan


Introduction: The progress of the systemic chemotherapy for colorectal cancer had revolutionized the therapy for metastatic liver tumors. It is found that there is the prognostic prolongation by hepatectomy after chemotherapy. On the other hand, it is found that there is high morbidity rate of hepatectomy after chemotherapy.
Aims & Methods: We report our experiences in laparoscopic two step hepatectomy. We have 107 cases of laparoscopic hepatectomy, and in 107 cases, we have one case of pure laparoscopic two step hepatectomy, and two cases of laparoscopic right portal vein ligation prior major hepatectomy. A 64-year-woman with multiple liver metastasis underwent chemotherapy by XELOX+ cetuximab, then we performed laparoscopic right posterior portal vein ligation and partial hepatectomies in left lobe of the liver. At 21st day after first operation, we performed laparoscopic extra posterior segmentectomy.
Results: Operation time was 272 minutes and blood loss was 519g. A little pleural effusion and abscess of hepatic aspect occurred and both morbidities relieved conservatively. The hospital stay after second operation was 20 days.
Conclusions: There is higher complication rate of hepatectomy after chemotherapy than hepatectomy without chemotherapy, so we expect pure laparoscopic two step hepatectomy is one of strategies for colorectal liver metastasis. Furthermore, in the therapy of colorectal metastasis to be possible to require polysurgery, it is useful of laparoscopic surgery which benefit has a little abdominal wall destruction

Session Number: Poster – Poster Presentations
Program Number: P376
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