title: Results of laparoscopic liver resection: retrospective study of 68 patients.
abstract: BACKGROUND
  Although an increasing number of reports and publications have dealt with the laparoscopic approach to liver resection, this procedure remains uncommon, and its feasibility, safety and effectiveness are still not established. There are few reports of the advantages of this approach on postoperative recovery.
  
  
  METHODS
  From December 1997 to March 2007, laparoscopic hepatic resection were performed in 68 patients.
  
  
  RESULTS
  There were 52 malignant tumors (36 hepatocellular carcinomas, three intrahepatic cholangiocarcinomas, one cystadenocarcinoma, liver metastases from ten colorectal carcinomas and two other organs) and 16 benign lesions among our 68 patients. Fifteen patients with hepatocellular carcinoma had cirrhosis. The mean tumor size was 3.1 +/- 1.8 cm (range 1.0-14.0 cm), and the tumors were located in every liver segment except segment I. Liver resection was anatomical in 17 patients and consisted of a lobectomy in four patients and a lateral segmentectomy in 13 patients. Non-anatomical resections were performed in 51 patients. The operative time was 214 +/- 93 min. Mean blood loss was 393 +/- 564 g. A hand-assisted laparoscopic method or mini-laparotomy method was required in 35 patients (51.4%). Operative complications occurred mainly in our early cases and included three patients (4.4%) with operative bleeding, 2 of whom (2.9%) requiring a conversion to open surgery. Postoperative complications occurred in seven patients (10.0%), and two of then eventually required a re-operation. The mean hospital stay was 17 days. There were no complications in the more recent cases.
  
  
  CONCLUSIONS
  The laparoscopic approach for liver tumors is feasible, if the indication is carefully selected. The safety of this procedure depends on the surgical experience of the surgeon and team and the availability of the necessary technology.
authors.affiliation: Department of Surgery, Yokoyama Hospital for Gastroenterological Diseases, Nagoya, Aichi, Japan. h.inagaki@yokoyama-hospital.or.jp
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Inagaki
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kurokawa
authors.forename: Tadashi
authors.initials: T
authors.lastname: Yokoyama
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Ito
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Yokoyama
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Nonami
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome