Laparoscopic Caudate Hepatectomy for Cancer

Kuo Hsin Chen, MD, Hsin-An Chen, MD, Chao-Chiang Tu, MD, Jiann-Ming Wu, MD, Kuo- Hsiang Cheng, MD, Shih-Horng Huang, MD PhD. General Surgery, Department of Surgery, Far-Eastern Memorial Hospital

Purpose:
To assess the safety, feasibility and clinical results of laparoscopic caudate hepatectomy for malignancy.

Materials and Methods:
From February 2006 to July 2010, we have performed laparoscopic hepatectomy for eight consecutive patients (six male two female; age: 42-75 years) with malignant caudate hepatic tumors. The patients suffered from hepatocellular carcinoma(HCC) (n=4) metastatic malignancy (n=4). The patients’ demographic data are listed in Table 1. After description and explanation of the minimal invasive method, all patients gave their informed consent. Prospectively, patients’ data, operating time, estimated blood loss, perioperative and postoperative complications, and outcome were collected.

Results:
All procedure for these eight patients with caudate hepatic tumors (size: 0.9-4.5 cm) were completed with totally laparoscopic technique except one which additional left hepatectomy was also done. The average operative time (OR time) was 254 min (range:210-345min) and estimated blood loss (EBL) was 202 ml (range: 10-1000 ml), average length of postoperative hospital stay was 6.9 days (rang:4-11 days). There was no perioperative complications and patient mortality in this series.

Conclusion:
Our experience demonstrated that laparoscopic hepatectomy is a safe and feasible procedure for caudate hepatic tumors in selected patients with tumor smaller than 6 cm in non cirrhotic liver.