Laparoscopic left hepatectomy with prior vascular control.
BACKGROUND
Laparoscopic major resections remain a challenge for liver surgeons. This video illustrates, step by step, our laparoscopic technique for left hepatectomy.


METHODS
The control of vascular inflow and outflow as well as the division of the left hepatic duct were carried out extraparenchymally before liver transection. Between 2002 and 2008, 11 left hepatectomies were performed by laparoscopy: 7 for liver tumor and 4 for localized Caroli's disease.


RESULTS
Mean duration of surgery was 248 +/- 25 min. Mean operative blood loss was 129 +/- 42 ml. Intraoperative blood transfusion or conversion to laparotomy were never required. One postoperative biliary collection occurred and was drained percutaneously. None of the patients died. Mean hospital stay was 7.6 +/- 2.2 days.


CONCLUSIONS
This technique has proved to be safe and easily reproducible.
Di Giuro
Giuseppe
G
Department of General Surgery, Antoine Béclère Hospital, AP-HP, 92140 Clamart, France.
Lainas
Panagiotis
P
Franco
Dominique
D
Dagher
Ibrahim
I
D006488:Hemostasis, Surgical; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008099:Liver / Q000098:blood supply / Q000601:surgery; D008107:Liver Diseases / Q000601:surgery*; D011183:Postoperative Complications; D016896:Treatment Outcome; D014741:Video Recording