Technical considerations in laparoscopic liver surgery.
BACKGROUND
Laparoscopic solid organ surgery has gained growing acceptance, but this does not hold for laparoscopic surgery of the liver. Laparoscopic liver surgery mainly comprizes diagnostic procedures and treatment of liver cysts. However, we believe there is room for a laparoscopic approach to the liver in selected cases, with the benefits that may be expected from laparoscopic solid organ surgery.


METHODS
Between 1993 and 2000, 10 patients with various lesions of the liver underwent laparoscopic surgery. Indications consisted of cystic disease (n = 2), hemangioma (n = 2), focal nodular hyperplasia (n = 2), liver abcess (n = 1), and liver metastasis (n = 3). Laparoscopic treatment varied from fenestration (n = 3) to wedge resections (n = 5), and formal left lateral hepatectomy (n = 2).


RESULTS
The mean patient age was 54 years (range, 34-71 years). The mean operative time, including laparoscopic ultrasonography, measured 180 min (range, 80-240 min). Peroperative blood loss ranged from 200 to 450 ml. There was no mortality. In two patients, conversion to laparotomy was necessary. There were no postoperative complications. The mean hospital stay was 6 days (range, 4-11 days).


CONCLUSIONS
Laparoscopic treatment should be considered in selected patients with benign and malignant lesions in the left lobe or frontal segments of the liver.
Berends
F J
FJ
Department of Surgery, University Hospital of the 'Vrije Universiteit' Amsterdam, De Boelelaan 1117, 1007 MB Amsterdam The Netherlands. fberends@worldonline.nl
Meijer
S
S
Prevoo
W
W
Bonjer
H J
HJ
Cuesta
M A
MA
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000556:secondary; D018572:Disease-Free Survival; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008107:Liver Diseases / Q000601:surgery*; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged