title: Laparoscopic liver resection without portal clamping: a prospective evaluation.
abstract: 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.
authors.affiliation: Department of Surgery-Liver Unit, Vita-Salute San Raffaele University, Via Olgettina, 60, 20132 Milan, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Pulitanò
authors.forename: Marco
authors.initials: M
authors.lastname: Catena
authors.forename: Marcella
authors.initials: M
authors.lastname: Arru
authors.forename: Eleonora
authors.initials: E
authors.lastname: Guzzetti
authors.forename: Laura
authors.initials: L
authors.lastname: Comotti
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Ferla
authors.forename: Luca
authors.initials: L
authors.lastname: Aldrighetti
mesh_terms: 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