Laparoscopic Versus Open Left Lateral Hepatic Lobectomy: A Case-Control Study

Lesurtel, Mickaël; Cherqui, Daniel; Laurent, Alexis; Tayar, Claude; Fagniez, Pierre Louis

doi:10.1016/s1072-7515(02)01622-8

Cited by 286 publications

(230 citation statements)

References 27 publications

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“…The lesion was hepatocellular adenoma and the patient underwent laparoscopic right hepatectomy by hand-assisted procedure. Mean (SD) tumor size measured on the surgical specimen was 50 (27) mm (range, 18-120 mm) ( Table 2). Preoperative radiological investigations included ultrasonography in all 50 patients, computed tomography in 41 patients (82%), and magnetic resonance imaging in 32 patients (64%).…”

Section: Resultsmentioning

confidence: 99%

Laparoscopic Liver Resection for Benign Disease

Ardito¹

2007

Arch Surg

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Patients: Fifty patients with benign disease underwent laparoscopic liver resection. Indications for resection included preoperative diagnosis of adenoma or cystadenoma, uncertain preoperative diagnosis, and presence of symptoms. Inclusion criteria were lesions 5 cm or less located in the peripheral segments (segments 2-6).Intervention: Laparoscopic liver resection using a surgical technique including 5 ports, harmonic transection, stapling of large vessels, and extraction in a bag through a separate incision.Main Outcome Measures: Intraoperative results and postoperative morbidity.Results: Thirty-five patients (70%) presented with solid tumor; 11 (22%), with cystic lesions; and 4 (8%), with biliary disease. Tumor was solitary in 41 cases (82%) and multiple in 9 (18%). Mean (SD) surgical time was 191 (77.5) minutes (range, 30-480 minutes). There were 4 conversions (8%) and 1 patient received a transfusion (2%). There was no mortality. The postoperative morbidity rate was 10% and included only nonspecific complications. Median hospital stay was 5 days.Conclusions: Laparoscopic liver resection for benign disease can be recommended in patients with peripheral lesions requiring limited resection. Major resections may be performed in highly select patients but require further evaluation. Specific training is required. Indications for laparoscopic resection of benign liver disease must be the same as those for open surgery. Reduction of abdominal wall damage and cosmetic advantages of the laparoscopic approach represent a clear benefit in patients with benign liver disease.

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Section: Resultsmentioning

confidence: 99%

Laparoscopic Liver Resection for Benign Disease

Ardito¹

2007

Arch Surg

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“…Laparoscopic left lateral sectionectomy (LLLS) is considered the most suitable anatomical liver resection to be performed laparoscopically [4,5,6] and many would anticipate that laparoscopy will be the gold standard approach for the resection of lesions in the left lateral segment. LLLS is seen as the most suitable procedure to perform during the early part of the learning curve to gain experience before progressing to major resections such as left and right lobectomies [4,7,8,9,10]. …”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Left Lateral Liver Sectionectomy: A Safe, Efficient, Reproducible Technique

Hilal

Pearce²

2008

Dig Surg

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Background: Laparoscopic left lateral sectionectomy (LLLS) is procedure with potential for future transformation into a primarily laparoscopic procedure where surgeons can safely develop laparoscopic experience and gain proficiency. Methods: Between August 2004 and December 2007, 80 patients underwent laparoscopic liver resections in our unit, 30 of these were left lateral sectionectomies. The indications for surgery were both oncological and non-oncological. Results: 30 LLLS were performed. Median operative time and median postoperative hospital stay group were 180 (40–340) min and 4 (1–6) days, respectively, and were noted to fall significantly between the first (15 patients) and second parts of this series. The median free resection margin was 11 (1.5–30) mm and median perioperative blood loss was 80 (25–800) ml. Two minor complications were observed with no mortality and no conversions to open. Conclusion: LLLS is a feasible, safe and efficient procedure, associated with a quick, smooth learning curve. We report our technique illustrating methods and particulars which would be of great help to surgeons developing new laparoscopic liver services.

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“…32 Several advances in laparoscopic instruments and operative technique have been made, and intraoperative blood loss is now lower compared with open hepatectomy. 33 Amongst them, RF has increasingly been used to minimize blood loss during hepatic parenchymal transection and to facilitate tissue-sparing liver resection. 14,34 In spite of these advantages, some authors have reported potential severe complication after RF-assisted liver resection.…”

Section: Discussionmentioning

confidence: 99%