Original article
Vol. 151 No. 0304 (2021)
Laparoscopic liver resection: a single-centre experience
- Michele Ghielmetti
- Michaela Ramser
- Daniel Oertli
Summary
BACKGROUND
The past 25 years have seen the increased use of minimally invasive surgery. The development of these techniques has impacted the domain of liver surgery. This study aimed to describe the safety, feasibility, benefits and results of laparoscopic liver resection in a single tertiary care centre.
METHODS
We reviewed the medical records of all patients who underwent liver surgery between January 2005 and December 2016 at the University Hospital of Basel. We selected all liver resections performed by laparoscopic surgery. To evaluate the results of the laparoscopic liver surgery, we chose the following data: the conversion rate from laparoscopy to open surgery, the median operating time, postoperative complications, the median length of stay following surgery and the median surgical margin in patients with malignant lesions.
RESULTS
Of the 274 liver operations, 201 (73%) were performed by open surgery and 73 (27%) by laparoscopy. Sixty-nine laparoscopic liver resections were included in this study. The selected laparoscopic liver resections were performed in 65 patients: 38 men and 27 women. The median age was 59 (range 29–85) years. Forty resections were performed for malignant lesions and 29 (42%) for benign diseases. The median operating time was 112 (range 50–247) minutes. The conversion rate was 19%. The most common cause for conversion was bleeding (69% of all conversions, 13% of all patients). Postoperative complications occurred in 15 patients (22%). The median hospitalisation time was 7.1 (range 2–23) days. Thirty-two patients (46.5% of all patients) had hepatocellular carcinoma. The mean tumour size was 25.6 (range 5–55) mm. The median surgical margin was 9 mm.
CONCLUSION
This study showed that in our centre laparoscopic liver surgery is a safe and effective treatment option for both benign and malignant liver lesions.
References
- Fallahzadeh MK, Zibari GB, Hamidian Jahromi A, Chu Q, Shi R, Shokouh-Amiri H. Laparoscopic versus open liver resection for benign and malignant solid liver tumors: a case-matched study. J Laparoendosc Adv Surg Tech A. 2013;23(11):908–11. doi:.https://doi.org/10.1089/lap.2013.0372
- Reddy SK, Tsung A, Geller DA. Laparoscopic liver resection. World J Surg. 2011;35(7):1478–86. doi:.https://doi.org/10.1007/s00268-010-0906-5
- Tranchart H, Dagher I. Laparoscopic liver resection: a review. J Visc Surg. 2014;151(2):107–15. doi:.https://doi.org/10.1016/j.jviscsurg.2013.10.003
- Chung CD, Lau LL, Ko KL, Wong AC, Wong S, Chan AC, et al. Laparoscopic liver resection for hepatocellular carcinoma. Asian J Surg. 2010;33(4):168–72. doi:.https://doi.org/10.1016/S1015-9584(11)60002-X
- Nguyen KT, Gamblin TC, Geller DA. World review of laparoscopic liver resection-2,804 patients. Ann Surg. 2009;250(5):831–41. doi:.https://doi.org/10.1097/SLA.0b013e3181b0c4df
- Dagher I, Belli G, Fantini C, Laurent A, Tayar C, Lainas P, et al. Laparoscopic hepatectomy for hepatocellular carcinoma: a European experience. J Am Coll Surg. 2010;211(1):16–23. doi:.https://doi.org/10.1016/j.jamcollsurg.2010.03.012
- Beard RE, Tsung A. Minimally Invasive Approaches for Surgical Management of Primary Liver Cancers. Cancer Contr. 2017;24(3):1073274817729234. doi:.https://doi.org/10.1177/1073274817729234
- Kirchberg J, Reißfelder C, Weitz J, Koch M. Laparoscopic surgery of liver tumors. Langenbecks Arch Surg. 2013;398(7):931–8. doi:.https://doi.org/10.1007/s00423-013-1117-y
- Buell JF, Cherqui D, Geller DA, O’Rourke N, Iannitti D, Dagher I, et al.; World Consensus Conference on Laparoscopic Surgery. The international position on laparoscopic liver surgery: The Louisville Statement, 2008. Ann Surg. 2009;250(5):825–30. doi:.https://doi.org/10.1097/SLA.0b013e3181b3b2d8
- Vibert E, Perniceni T, Levard H, Denet C, Shahri NK, Gayet B. Laparoscopic liver resection. Br J Surg. 2006;93(1):67–72. doi:.https://doi.org/10.1002/bjs.5150
- Zhou Y-M, Shao W-Y, Zhao Y-F, Xu D-H, Li B. Meta-analysis of laparoscopic versus open resection for hepatocellular carcinoma. Dig Dis Sci. 2011;56(7):1937–43. doi:.https://doi.org/10.1007/s10620-011-1572-7
- Dagher I, Lainas P, Carloni A, Caillard C, Champault A, Smadja C, et al. Laparoscopic liver resection for hepatocellular carcinoma. Surg Endosc. 2008;22(2):372–8. doi:.https://doi.org/10.1007/s00464-007-9487-2
- Xiong J-J, Altaf K, Javed MA, Huang W, Mukherjee R, Mai G, et al. Meta-analysis of laparoscopic vs open liver resection for hepatocellular carcinoma. World J Gastroenterol. 2012;18(45):6657–68. doi:.https://doi.org/10.3748/wjg.v18.i45.6657
- Aldrighetti L, Guzzetti E, Pulitanò C, Cipriani F, Catena M, Paganelli M, et al. Case-matched analysis of totally laparoscopic versus open liver resection for HCC: short and middle term results. J Surg Oncol. 2010;102(1):82–6. doi:.https://doi.org/10.1002/jso.21541
- Sarpel U, Hefti MM, Wisnievsky JP, Roayaie S, Schwartz ME, Labow DM. Outcome for patients treated with laparoscopic versus open resection of hepatocellular carcinoma: case-matched analysis. Ann Surg Oncol. 2009;16(6):1572–7. doi:.https://doi.org/10.1245/s10434-009-0414-8
- Lee KF, Chong CN, Wong J, Cheung YS, Wong J, Lai P. Long-term results of laparoscopic hepatectomy versus open hepatectomy for hepatocellular carcinoma: a case-matched analysis. World J Surg. 2011;35(10):2268–74. doi:.https://doi.org/10.1007/s00268-011-1212-6
- Belli G, Fantini C, D’Agostino A, Cioffi L, Langella S, Russolillo N, et al. Laparoscopic versus open liver resection for hepatocellular carcinoma in patients with histologically proven cirrhosis: short- and middle-term results. Surg Endosc. 2007;21(11):2004–11. doi:.https://doi.org/10.1007/s00464-007-9503-6
- Kim HH, Park EK, Seoung JS, Hur YH, Koh YS, Kim JC, et al. Liver resection for hepatocellular carcinoma: case-matched analysis of laparoscopic versus open resection. J Korean Surg Soc. 2011;80(6):412–9. doi:.https://doi.org/10.4174/jkss.2011.80.6.412
- Laurent A, Tayar C, Andréoletti M, Lauzet J-Y, Merle J-C, Cherqui D. Laparoscopic liver resection facilitates salvage liver transplantation for hepatocellular carcinoma. J Hepatobiliary Pancreat Surg. 2009;16(3):310–4. doi:.https://doi.org/10.1007/s00534-009-0063-0
- Cheng Y, Zhang L, Li H, Wang L, Huang Y, Wu L, et al. Laparoscopic versus open liver resection for colorectal liver metastases: a systematic review. J Surg Res. 2017;220:234–46. doi:.https://doi.org/10.1016/j.jss.2017.05.110
- Cugat E, Pérez-Romero N, Rotellar F, Suárez MA, Gastaca M, Artigas V, et al. Laparoscopic liver surgery: 8 years of multicenter Spanish register. J Hepatobiliary Pancreat Sci. 2010;17(3):262–8. doi:.https://doi.org/10.1007/s00534-009-0170-y
- Yoon Y-S, Han H-S, Cho JY, Ahn KS. Total laparoscopic liver resection for hepatocellular carcinoma located in all segments of the liver. Surg Endosc. 2010;24(7):1630–7. doi:.https://doi.org/10.1007/s00464-009-0823-6
- Koffron AJ, Auffenberg G, Kung R, Abecassis M. Evaluation of 300 minimally invasive liver resections at a single institution: less is more. Ann Surg. 2007;246(3):385–92, discussion 392–4. doi:.https://doi.org/10.1097/SLA.0b013e318146996c
- Shehta A, Han H-S, Yoon Y-S, Cho JY, Choi Y. Laparoscopic liver resection for hepatocellular carcinoma in cirrhotic patients: 10-year single-center experience. Surg Endosc. 2016;30(2):638–48. doi:.https://doi.org/10.1007/s00464-015-4253-3