Backgrounds and Purposes ; Recently, the laparoscopic resection on solid organs is performed in standard operation style with the improvement of the laparoscopic instrument and the developing operation technique. Still, it is not easy to perform liver exploration by using the laparoscope. Because there are still other problems, such as the styptic matter against bleeding, difficulty of the operation technique, insufficient instrument, room and visual field for surgery. As a result, laparoscope operation has limited disease for which medicine is efficacious on some part of it. For this reason, we have studied that liver resection treat by using laparoscope will be the safe and efficient remedy for the patients who suffer from liver cancer spreaded from hepatolithiasis and HCC (hepatocellularcarcinoma), colon cancer.
Objects and Methods; We researched 32 people: 20 patients with IHD stone, 4 with HCC (hepatocellularcarcinoma), 1 with cholangiocarcinoma, 7 patients who had colon cancer spread to liver. By using retrospective method, these patients are observed on the clinical history, ways of surgery, time for the operation, hospital day, and complication.
Results ; The target age range was from 37 to 80 and the average was 61 years old. People aged over 60 was around 62.5%. The spread of men and women was 16 against 16. According to their medical history, 9 patients had experiences for upper abdominal operation. There were 4 patients with three S3 and one for S6, both of them had had HCC (hepatocellularcarcinoma). When it comes to the seven patients, who had colon cancer and spreaded to liver, there were 2 for S3, 4 for S4 and 1 for S7&8. In a operation, 4 to 5 ports were used. And there were 8 cases of Lt. lateral sectionectomy(25%), another 9 cases for Lt. hepatectomy(28,1%) of Lt. hepatolithiasis. 2 cases among the 11 cases of wedge resection of liver, were HCC and 7 cases ( 2 for S3, 4 for S4, 1 for S7&8)were who had colon cancer with liver metastasis. Lt. lateral sectionectomy was performed for 2 cases of HCC and 1 cases of cholangiocarcinoma were had Lt. hepatectomy. The average period of the operation was 335 minutes, bleeding amount was 404cc and the average period in hospitality was 14 days. There were 2 cases of bile leak on the part from hepatic resection complication, 1 case of intrabdominal abscess, 1 with acute renal failure after surgery, 2 with wound infection. All of cases were recuperated in hospital and there was no another surgical operation or death.
There was one case remained IHD stone, which had surgical treat for hepatolithiasis. There was also a patient who had peritoneal relapse, which had surgical treat for HCC. And he was detected for in early stage.
Conclusion ; Hepatectomy with laparoscope have some advantages – less pain after operation, relatively small incision site, the short period of hospital day and less time for back to the routine. It is as effective as laparotomy.
As the trend that, currently, considers the laparoscope treat as priority, the laparoscopic approach would be the important guideline for curing hepatolithiasis and HCC (hepatocellular carcinoma) through the improving surgical instrument and the way of operation.
Program Number: P443