Laparoscopic liver resection for benign disease.
OBJECTIVE
Resection for benign liver disease can represent a valid indication for the laparoscopic approach.


METHODS
Prospective case series.


METHODS
Tertiary referral center.


METHODS
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).


METHODS
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.


METHODS
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.
Ardito
Francesco
F
Department of Digestive Surgery, Henri Mondor Hospital, 51 avenue du Mal de Lattre de Tassigny, 94010 Créteil CEDEX, France.
Tayar
Claude
C
Laurent
Alexis
A
Karoui
Mehdi
M
Loriau
Jerome
J
Cherqui
Daniel
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006498:Hepatectomy; D006801:Humans; D010535:Laparoscopy; D008107:Liver Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies