title: Lessons from laparoscopic liver surgery: a nine-year case series.
abstract: OBJECTIVE
  This series describes a developing experience in laparoscopic liver surgery presenting results from 40 procedures including right hemihepatectomy, left lateral lobectomy, and microwave ablation therapy.
  
  
  METHODS
  Forty patients undergoing laparoscopic liver surgery between September 1997 and November 2006 were included. The data set includes: operative procedure and duration, intraoperative blood loss, conversion to open operation rates, length of hospital stay, complications, mortality, histology of lesions/resection margins, and disease recurrence.
  
  
  RESULTS
  Mean age of patient: 59 years, 17/40 male, 23/40 female, 23/40 of lesions were benign, and 17/40 malignant. Operations included: laparoscopic anatomical resections n = 15, nonanatomical resections n = 11, microwave ablations n = 8 and deroofing of cysts n = 7. Median anaesthetic time: 120 minutes (range 40-240), mean blood loss 78 mL and 1/40 conversions to open. Median resection margins were 10 mm (range 1-14) and median length of stay 3 days (range 1-10). Operative and 30-day mortality were zero with no local disease recurrence.
  
  
  CONCLUSIONS
  Laparoscopic liver surgery appears safe and effective and is associated with reduced hospital stay. Larger studies are required to confirm it is oncologically sound.
authors.affiliation: Department of Hepatobiliary and Laparoscopic Surgery, Leicester Royal Infirmary, Leicester University, Infirmary Square, Leicester LE1 5WW, UK.
authors.forename: Laura
authors.initials: L
authors.lastname: Spencer
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Metcalfe
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Strickland
authors.forename: Elisabeth J
authors.initials: EJ
authors.lastname: Elsey
authors.forename: Gavin S
authors.initials: GS
authors.lastname: Robertson
authors.forename: David M
authors.initials: DM
authors.lastname: Lloyd