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Laparoscopic liver resection-experience of 436 patients in one center

Tehung Chen, MD, Shih-Chao Hsu, Chun-Chieh Yeh, Horng-Ren Yang, Mei-Due Yang, Long-Bin Jeng. China Medical University Hospital

Purpose: We report our experience with laparoscopic liver resection in China Medical University Hospital.

Materials and methods: Retrospectively analysis of prospective collective clinical data of two hundred twenty one patients, received laparoscopic liver resections from December, 2010 to December, 2016.

Result: During this period 1022 patients received traditional liver resection and 436 patients received laparoscopic liver resection. The indications for laparoscopic hepatic resection include HCC( n=195), Colorectal carcinoma liver metastasis (n=156), benign tumors (n=62), IHD stones (n=1), and other malignant lesions (n=22). The mean tumor size was 29.3 mm+-19.3 mm (3 mm to 130 mm). The tumor location include all segments. Minimally invasive approach to liver resection include pure laparoscopic (n=427) and laparoscopic assisted ‘‘hybrid’’ approach (n=9). Types of resections include Wedge resection/segmentectomy (n=238), two segmentectomy (n=13), Left lateral sectionectomy (n=75), Right hepatectomy (n=52), Left hepatectomy (n=30), Extended right lobectomy (n=2), Extended left hepatectomy (n=5), Central segmentectomy (n=3), Right posterior resection (n=13) and right anterior resection (n=5). The mean operation time was 254.8+-144.0 minutes, mean blood loss was 282.7+-401.8 ml, and twenty five patients need blood transfusion (5.7%). Conversion to open surgery was required in 6 patients (1.37%). Reasons for conversion were instrument failure in one patient and uncontrolled bleeding in five patients. The mean length of stay was 6.4+-2.9 days (3-38 days). Forty one patient developed complications (9.4%), including eight bile leaks (1.8%), four intraabdominal abscesses(0.9%) and seven wound dehiscence(1.6%), two incision hernia, two ileus, seven excess ascites, and two liver insufficiencies. One patient died of postoperative liver failure. Overall and recurrence-free survival rates of patient with HCC at 1, 3, and 5 years were 96.9%, 94.7%, 87.5%, and 83.0%, 65.1%, 55.4%, respectively(Median follow up time 48.2 months).

Conclusion: This study demonstrates that laparoscopic approach is feasible in selected patients with good operative and oncologic results.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 85286

Program Number: S061

Presentation Session: Liver/Pancreas Session

Presentation Type: Podium

36

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