Laparoscopic liver resections: A single center experience

Dulucq, Jean-Louis; Wintringer, P.; Stabilini, Cesare; Berticelli, J.; Mahajna, Ahmad

doi:10.1007/s00464-004-2044-3

Cited by 109 publications

(75 citation statements)

References 23 publications

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“…Machado, et al 14,15 did not observe comprised margins, although the series was small and almost all cases were colorectal metastasis. Like in other series, there was no mortality in the present series which leads to think that laparoscopic hepatectomy is generally a safe procedure 1,2,3,4,5,6,7,8,9,10,11,12,14,15,17,18 .…”

Section: Discussionsupporting

confidence: 76%

“…Hilar dissection, biliary or vascular repair, mobilization of the liver, and transection of the parenchyma are more technically demanding and potentially more dangerous than other laparoscopic procedures that have previously been reported. Anatomical hemihepatectomy requires a clear understanding of general liver anatomy, experience in advanced hepatobiliary surgery, and additionally, the ability to dissect major vascular and biliary structures using laparoscopic approach 1,2,3,4,5,6,11 .…”

Section: Discussionmentioning

confidence: 99%

“…With advances in laparoscopic instruments and parenchymal transection devices associated with improved experience of complex laparoscopic hepatobiliary resections; the use of laparoscopic hepatic resection has been growing, especially formal right hepatectomy or even mono and bi-segmentectomy of the right lobe. More recently, laparoscopic hepatectomy has been performed with dismal morbidity and low mortality in some referral centers 1,2,3,4,5,6,10,11,12,13,14,15,17,18 .…”

Section: Introductionmentioning

confidence: 99%

“…Não houve mortalidade e a morbidade foi nula. A mediana de internação foi de três dias (2)(3)(4)(5). A mediana de retorno às atividades cotidianas foi de 12 dias (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20).…”

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“…A mediana de retorno às atividades cotidianas foi de 12 dias (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). A mediana de seguimento foi de 13 meses (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). Não houve recidiva de lesão.…”

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Setorectomia posterior direita laparoscópica no tratamento dos tumores hepáticos

Costa¹,

Araujo²,

Teixeira³

2010

ABCD, arq. bras. cir. dig.

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HEADINGS -Laparoscopy. Hepatectomy. Liver neoplasms/surgery. Neoplasic metastases.ABSTRACT -Background -Resection of neoplasms arising in the posterior right sector is usually a technical challenge due to approach difficulties. Additionally, laparoscopic hepatectomy has become an interesting alternative with several advantages (low morbidity, short hospital stay, early return work activities and good cosmetic results). Aim -To report a series of patients who underwent laparoscopic right posterior sectioniectomy performed by a single surgical team. Methods -Five patients were operated. Their ages ranged from 21 to 63 years (median 43 years). There were four women and one man. Etiology of the neoplasm was: adenoma (n=2), hepatocellular carcinoma (n=1) and metastasis (n=2). There was a single lesion in three cases (60 %). The mean lesion diameter was 3,3 cm (1,8-5). It was analyzed: operative time, intraoperative bleeding, morbidity, length of stay and time of return to usual activity. Results -The mean surgical time was 160 minutes (90-260). The mean intraoperative blood loss was 200 ml (0-500). None of the patients received transfusions. There was no mortality and no morbidity. The median hospital stay was three days (2-5). The median length of time taken to return to day-to-day activities was 12 days (7-20). The median follow-up period was 13 months (1-20). There was no tumor recurrence. Conclusion -Laparoscopic right posterior sectioniectomy (bi-segmentectomy VI + VII) is a good option to treat hepatic tumors located in the posterior sector of the right lobe. It is a safe procedure that avoids large incisions with no mortality or morbidity is this series. This approach also bring good cosmetic result and early return to work.RESUMO -Introdução -A ressecção de neoplasias no setor posterior direito costuma ser um desafio técnico pela dificuldade de sua abordagem. Adicionalmente, as hepatectomias laparoscópicas tem se tornado alternativa interessante em virtude de muitas vantagens (baixa morbidade, curto tempo de internação, retorno precoce as atividades laborais e bons resultados cosméticos). Objetivo -Relatar experiência em doentes submetidos à setorectomia posterior direita laparoscópica por uma única equipe. Métodos -Cinco doentes foram operados entre novembro de 2008 a agosto de 2010. A idade variou de 21 a 63 anos com mediana de 43 anos. Foram quatro mulheres e um homem. A causa das neoplasias foi: adenoma (n=2), hepatocarcinoma (n=1) e metástases (n=2). A lesão foi solitária em três casos (60 %). A média do tamanho das lesões foi 3,3 cm (1,8-5). Foram analisados: tempo cirúrgico, sangramento operatório, morbimortalidade, tempo de internação e tempo de retorno à atividade habitual. Resultados -A média de tempo cirúrgico foi de 160 minutos (90-260). A de sangramento intra-operatório foi de 200 ml (0-500). Nenhum doente foi transfundido. Não houve mortalidade e a morbidade foi nula. A mediana de internação foi de três dias (2-5). A mediana de retorno às atividades cotidianas foi de 12 dias (7-20). A mediana de...

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

unclassified

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Setorectomia posterior direita laparoscópica no tratamento dos tumores hepáticos

Costa¹,

Araujo²,

Teixeira³

2010

ABCD, arq. bras. cir. dig.

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Totally Robotic Right Hepatectomy

Giulianotti¹

2011

Arch Surg

109

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Main Outcome Measures: Intraoperative blood loss, operative time, morbidity, mortality, and long-term oncologic follow-up. Results: The procedure was converted to open surgery in 1 patient (4.2%). The overall mean (SD) operative time was 337 (65) minutes (range, 240-480 minutes), and the mean (SD) intraoperative blood loss was 457 (401) mL (range, 100-2000 mL). Three patients (12.5%) underwent blood transfusion. There were no perioperative deaths and no reoperations. Six patients (25.0%) experienced postoperative morbidity, including transitory liver failure in 2 patients and pleural effusion, bile leak, fluid collection, and deep venous thrombosis in 1 patient each. The patients' diagnoses included colorectal liver metastases (n=11), noncolorectal liver metastases (n=4), hemangioma (n=4), adenoma (n=2), hepatocellular carcinoma (n = 1), hepatoblastoma (n = 1), and biliary amartoma (n = 1). At a mean follow-up duration of 34 months, no port site metastases were observed in patients with malignant pathologic findings. Conclusions: The zero mortality and acceptable morbidity of our series indicate that in experienced hands, robotic right hepatectomy is feasible and safe. Robotic surgery offers a new technical option for minimally invasive major hepatic resections. Long-term results seem to confirm oncologic effectiveness of the procedure.

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