Laparoscopic liver resection without portal clamping: a prospective evaluation.
BACKGROUND
Previous comparative studies have demonstrated that laparoscopic liver resection is associated with more frequent use and longer duration of portal camping than open liver resection, a fact that may partially explain the improvement in operative blood loss reported by most series of laparoscopic liver resection. The aim of this prospective study was to evaluate the real need for portal clamping in laparoscopic liver surgery.


METHODS
Surgical outcomes of 40 consecutive patients who underwent laparoscopic liver resection for benign and malignant lesions from September 2005 to August 2007 were evaluate. Portal clamping was not systematically used.


RESULTS
No patient required blood transfusion and median blood loss was 160 ml (range 100-340 ml). Mean operating time was 267 min (range 220-370 min) and portal clamping was necessary in only one patient. Surgical complications included two grade I complication, three grade II, and one case of postoperative hemorrhage (grade III).


CONCLUSIONS
Laparoscopic liver surgery without clamping can be performed safely with low blood loss.
Pulitanò
Carlo
C
Department of Surgery-Liver Unit, Vita-Salute San Raffaele University, Via Olgettina, 60, 20132 Milan, Italy.
Catena
Marco
M
Arru
Marcella
M
Guzzetti
Eleonora
E
Comotti
Laura
L
Ferla
Gianfranco
G
Aldrighetti
Luca
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult