Laparoscopic-assisted liver resection.
OBJECTIVE
The recent rapid development of innovative laparoscopic instruments and improvements in surgical skill have made laparoscopic-assisted liver resection possible. Obviously, extensive experience in laparoscopic and hepatobiliary surgery is mandatory in carrying out liver resection through the minimal access approach. Here, we describe and evaluate our results during the period 1998-2001.


METHODS
During this period we attempted laparoscopic-assisted liver resection in 11 patients. There were 8 female and 3 male patients, of mean age 57.2 years (range, 28-68 years).


RESULTS
In all but 1 patient, the laparoscopic operation was successfully performed. Indications included recurrent pyogenic cholangitis (RPC; n = 6), hepatocellular carcinoma ( n = 3), colorectal liver secondary ( n = 1), and hemangioma ( n = 1). The mean +/- SD operating time was 190 +/- 62.4 min (range, 60-290 min), and mean +/- SD blood loss was 394 +/- 241 cc (range, 200-1000 cc). All patients but 1 were discharged within 2 weeks after the operation, and in this 1 patient, the prolonged hospital stay was due to postoperative bile leak, which was managed by combined percutaneous and endoscopic biliary drainage. With a mean follow-up of 10 months, there was no significant long-term complication.


CONCLUSIONS
In summary, laparoscopic-assisted liver resection is a feasible and safe treatment option for various liver pathologies, such as RPC and primary and secondary liver tumors.
Tang
Chung-Ngai
CN
Department of Surgery, Pamela Youde Nethersole Eastern Hospital, 3, Lok Man Road, Chai Wan, Hong Kong.
Li
Michael Ka-Wah
MK
D000328:Adult; D000368:Aged; D002761:Cholangitis / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D016896:Treatment Outcome