Initial experience with cantilever powered stapler in laparoscopic liver resection

Abstract

Background: Purpose of our study was to evaluate the safety and effectiveness of laparoscopic liver resection (LLR) in patients with hepatocellular carcinoma (HCC) and to compare LLR with open liver resection (ORL) in this setting. Methods: Our cohort consisted in patients who underwent liver resection for HCC between December 2006 and August 2015 in our institution. A preliminary sample of 50 patients was identified; 26 patients received LLR and 24 had ORL. Intraoperative variables, such as operative time and estimated blood loss, as well as perioperative outcomes were assessed for both techniques. Results: Patients who received LLR had shorter operative time, less blood loss, and reduced length of stay. Operative time and blood loss were respectively 177 min versus 225 min and 107 mL versus 312 mL between the two groups. The LLR cohort had an average length of stay of 7 days, while the ORL patients were hospitalized for an average of 16 days. Resume of oral intake and full patient mobilization were quicker after LLR. Conclusions: Even in our preliminary experience, LLR confirmed to be a safe, effective and feasible approach in selected patients, including those with malignancy, being associated with minor blood loss, reduced overall operative time, short hospital stay and a prompt return to a regular diet and physical activity with acceptable oncological outcomes.Still, a long-term follow-up is needed to draw definitive conclusions in terms of long-term survival benefits.