Laparoscopic liver surgery. A report on 28 patients.
BACKGROUND
An effort was made to evaluate the indications, safety, and therapeutic efficacy of laparoscopic liver surgery.


METHODS
Between 1989 and 1996, 28 patients, 23 to 88 years old were operated upon laparoscopically. Pathology consisted of simple cyst (ten), polycystic liver disease (seven), hydatid cyst (three, two of them calcified), abscess (one), focal nodular hyperplasia (six), and metastatic breast cancer (one).


RESULTS
Operations included 17 fenestrations, three pericystectomies, and eight resections (two lateral lobes). Operative time was 45 to 525 min with only four cases longer than 4 h. There was a 21% morbidity rate. There were no mortalities. Follow-up was 1-67 months with one asymptomatic recurrence.


CONCLUSIONS
Laparoscopic hepatic surgery can be performed safely with good results by surgeons with hepatic and laparoscopic experience when careful selection criteria are followed. We advocate the "four-hands technique" for simultaneous dissection and control of bleeding and bile ducts during resections.
Marks
J
J
Department of Surgery, Allegheny University of the Health Sciences, Hahnemann Division, Philadelphia, PA 19102-1192, USA.
Mouiel
J
J
Katkhouda
N
N
Gugenheim
J
J
Fabiani
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003560:Cysts / Q000601:surgery; D004444:Echinococcosis, Hepatic / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008100:Liver Abscess / Q000601:surgery; D008107:Liver Diseases / Q000601:surgery*; D008113:Liver Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome