Laparoscopic Liver Resection for Tumors in the Left Lateral Liver Section

Abstract

Background:The laparoscopic approach is increasingly adopted for liver resections today especially for lesions located in the left lateral liver section. This study was conducted to determine the impact of the introduction of laparoscopic liver resection (LLR) as a surgical option for suspected small- to medium-sized (<8 cm) tumors located in the left lateral section (LLS).Methods:This is a retrospective review of 156 consecutive patients who underwent LLR or open liver resection (OLR) of tumors located in the LLS. The study was divided into 2 consecutive periods (period 1, January 2003 through September 2006, and period 2, October 2006 through April 2014); LLR was available as a surgical option only in the latter period. Comparisons made were LLR versus OLR, LLR versus OLR (in period 2 only), and resections performed in period 1 versus period 2.Results:Forty-two patients underwent LLR with 4 conversions. LLR was significantly associated with a longer median operative time [167.5 minutes (range, 60–525) vs 105 minutes (range, 40–235); P < .001], decreased need for the Pringle maneuver [n = 1 (2%) vs 22 (19%); P = .008], and shorter postoperative stay [n = 4 (range, 1–10) days vs 5 days (range, 2–47); P < .001] compared with open resection. Comparison of the 42 patients who underwent LLR with the 64 contemporaneous patients who underwent OLR demonstrated similar outcomes. Again, LLR was associated with a significantly longer operation, decreased need for the Pringle maneuver, and shorter hospital stay.Conclusions:LLR can be safely adopted to treat lesions in the LLS. The procedure is associated with a shorter postoperative stay and a decreased need for the Pringle maneuver, but longer operative time compared with that required for OLR.

The Asia Pacific Consensus Statement on Laparoscopic Liver Resection for Hepatocellular Carcinoma: A Report from the 7th Asia-Pacific Primary Liver Cancer Expert Meeting Held in Hong Kong

“…However, the number of cases published has been rapidly increasing to more than 9,000. Many of these cases were reported in the form of case series [14][15][16][17], case control study [18][19][20][21][22][23][24][25][26][27][28], or systematic review and meta-analysis [5,6,[29][30][31][32]. Many specialized centers of liver cancer management are now entering the exploration and assessment phase.…”

Early experience with robot-assisted laparoscopic hepatobiliary and pancreatic surgery in Singapore: single-institution experience with 20 consecutive patients

“…Subsequently, this centre also reported their experience with laparoscopic common bile duct exploration. (22,23) More recently, several larger case series (1,24,25) on LH and LP (7,26) from other centres in the country, including our institution, have been reported. However, experience with RAL HPB surgery in Singapore remains extremely limited; the first two reports (27,28) from our centre were only published very recently, in 2016.…”

Laparoscopic left lateral sectionectomy: A three-port method

“…Based on a literature review of conventional LLS,[ 4 10 11 12 13 14 15 16 17 18 19 20 ] the median operative time was 120–320 min, median blood loss was 0–236 mL and the incidence of morbidity was 0–16.(7%). When compared with these results, the present 3-port technique seems not inferior to the conventional LLS with regard to short-term surgical outcomes.…”