Laparoscopic liver surgery: 8 years of multicenter Spanish register.
BACKGROUND
To present the data of laparoscopy in liver surgery and to assess the real indications and outcomes of this kind of approach.


METHODS
From February 2000 to March 2008, a prospective study was performed on 182 patients from 15 Spanish surgical centres.


RESULTS
A total of 308 lesions was collected. The mean age was 57 years old, and 61.5% were female. Among patients with cystic lesions we found: 45 simple cysts, 19 policystic diseases, 12 hydatidic cysts and 2 cystoadenomas. Among solid lesions (n = 104), we found 34 patients with benign pathology (12 focal nodular hyperplasia, 10 adenomas, 7 haemangyomas and 5 other lesions) and 70 with malignant pathology (38 metastases, 29 hepatocellular carcinomas, 2 cholangiocarcinomas and 1 lymphoma). The global rate of conversion was 8.8%. The global morbidity rate was 14.8%, and 5 of them required re-intervention.


CONCLUSIONS
Nowadays there are strong criteria for patients being submitted to laparoscopy procedures based both on type and location features. The postoperative morbidity rate is low, also for hepatocellular carcinoma in cirrhotic liver. In case of malignant pathology, we think the use of ultrasonography is mandatory to obtain a free margin, which implies a long-term survival rate.
Cugat
Esteve
E
Hepato-Bilio-Pancreatic Unit of Hospital Mutua de Terrassa, C/Plaza Dr Robert no 5, 08221, Terrassa, Barcelona, Spain. 21202eca@comb.es
Pérez-Romero
Noelia
N
Rotellar
Fernando
F
Suárez
Miguel A
MA
Gastaca
Mikel
M
Artigas
Vicente
V
Olsina
Jorge-Juan
JJ
Noguera
José
J
Martínez
Sagrario
S
Moreno-Sanz
C
C
Figueras
Joan
J
Herrera
Javier
J
Díaz
Hermógenes
H
Caballé
Jordi
J
Pereira
Fernando
F
D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008107:Liver Diseases / Q000601:surgery*; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D012042:Registries; D013030:Spain