Laparoscopic left hemihepatectomy: a safety and feasibility study of 19 cases.
BACKGROUND
Laparoscopic liver resection was performed at some institutes. The procedure mainly included local resection, segmentectomy, and left lateral segmentectomy. With experience accumulation and technique innovation, laparoscopic left hemihepatectomy was performed in selected patients. This study was designed to introduce and evaluate the safety and feasibility of this procedure.


METHODS
Nineteen successive patients underwent laparoscopic left hemihepatectomy from 2005 to 2007. They were compared by the matched-pair method with 19 other patients who underwent conventional open left hemihepatectomy. Surgical feature, postoperative course, and the learning curve of laparoscopic left hemihepatectomy were studied.


RESULTS
Laparoscopic hemihepatectomy was successfully performed in 17 cases. Two conversions were required. Compared with the open group, the blood loss was significantly less in the laparoscopic group (462 +/- 372 vs. 895 +/- 704, p = 0.03). Postoperative hospital stay of the laparoscopic group was shorter but not significant compared with the open group (9 +/- 5 vs. 13 +/- 7, p = 0.086). Postoperative albumin level in the laparoscopic group was significantly higher than the open group (33 +/- 4.8 vs. 27.6 +/- 3.2, p = 0.001). There was no perioperative mortality in either group. Two complications occurred in the laparoscopic group (11%) and four in the open group (21%). A tendency of gradually decreased transecting time was noticed in the early cases (R(2) = 0.676; p = 0.012).


CONCLUSIONS
Laparoscopic left hemihepatectomy is a safe and feasible procedure for select patients.
Institute of Minimally Invasive Surgery, Zhejiang University, Hangzhou, 310016, China. anwyf@163.com
Xiu-Jun
XJ
Cai
Yi-Fan
YF
Wang
Yue-Long
YL
Liang
Hong
H
Yu
Xiao
X
Liang
D000328:Adult; D016063:Blood Loss, Surgical / Q000503:physiopathology; D002681:China; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D007813:Laparotomy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000503:physiopathology; D011183:Postoperative Complications / Q000453:epidemiology; D011336:Probability; D018570:Risk Assessment; D017751:Safety Management; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome