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