Laparoscopic Hepatectomy

K FURUTA, MD PhD, H KATAGIRI, MD PhD, K ISHII, MD PhD, M KUMASMOTO, MD PhD, Y TAKAHASHI, MD PhD, H KAMATA, MD, H KAWAMATA, MD, K NAKAMURA, MD, M WARAYA, MD, M WATANABE, MD PhD. Kitasato University

INTRODUCTION: A laparoscopic approach to liver disease is increasingly performed although its ultimate benefit is yet to be confirmed. Laparoscopic hepatectomy is gradually gaining acceptance as an alternative to open resection in selected patients. The aim of this study is to report our initial institution experience with laparoscopic hepatectomy.
METHODS: We performed 22 hepatectomies by the laparoscopic approach. These 22 patients were included in the study with varyingly pre-operative diagnosis such as hepatocellular carcinoma(15 patients), hepangimoma(2 patients), metastatic liver tumor (3 patients), focal nodular hyperplasia(1 patient) and hemangiomyolipoma(1 patient).The median age was 61.9 years (21-79) with a female to male ratio of 11:11.
Median number (1) and maximum diameter(38mm(10-100mm)) were comparable in patients undergoing laparoscopic liver resection. Sixteen left lateral lobectomy, 5 local resection and one right lobectomy were performed.
RESULTS: Median intraoperative blood loss was 223 (10-1950) ml. Median operation time was 180 (67-445) minutes. Of the 22 patients, two were converted to an open procedure due to an uncertain adhesion and inadequate exposure.
The length of stay was 9.3 days (3-16). These were no morbidities and no mortalities. Of the patients that successfully underwent the procedure laparoscopically, and these were no morbidities. With a follow up, 18 patients with a diagnosis of malignancy have 3 patients of recurrent disease. These 3 patients have no local recurrent.
CONCLUSIONS: A minimally invasive approach to hepatic disease is safe and technically feasible with acceptable morbidity.