title: Surgical management of benign and indeterminate hepatic lesions in the era of laparoscopic liver surgery.
abstract: OBJECTIVE
  The expansion of the laparoscopic approach for the management of benign liver lesions has raised concerns regarding the risk of widening surgical indications and compromising safety. Large single-centre series focusing on laparoscopic management of benign liver lesions are sporadic.
  
  
  METHODS
  We reviewed a prospectively collected database of patients undergoing pure laparoscopic liver resection (LLR) for benign liver lesions. All cases were individually discussed at a multidisciplinary team meeting.
  
  
  RESULTS
  Forty-six patients underwent 50 LLRs for benign disease. Indications for surgery were: symptomatic lesions, preoperative diagnosis of adenoma or cystadenoma, and lesions with an indeterminate diagnosis. The preoperative diagnosis was uncertain in 11 cases. Of these, histological diagnosis was hepatocellular carcinoma in one (9%) and benign lesion in 10 patients (91%). Thirteen patients (28%) required major hepatectomy. Three patients (7%) developed postoperative complications. Mortality was nil. The median postoperative hospital stay following major and minor hepatectomy was 4 and 3 days, respectively.
  
  
  CONCLUSIONS
  The laparoscopic approach represents a safe option for the management of benign and indeterminate liver lesions, even when major hepatectomy is required. LLR should be only performed in specialized centres to ensure safety and strict adherence to orthodox surgical indication.
authors.affiliation: Hepatobiliary-Pancreatic and Laparoscopic Surgical Unit, Southampton General Hospital, Southampton University Hospitals NHS Trust, Southampton, UK. Mail abu_hlal @ yahoo.com
authors.forename: Mohammed
authors.initials: M
authors.lastname: Abu Hilal
authors.forename: Francesco
authors.initials: F
authors.lastname: Di Fabio
authors.forename: Mabel Joey
authors.initials: MJ
authors.lastname: Teng
authors.forename: Dean Anthony
authors.initials: DA
authors.lastname: Godfrey
authors.forename: John Neil
authors.initials: JN
authors.lastname: Primrose
authors.forename: Neil William
authors.initials: NW
authors.lastname: Pearce
mesh_terms: D000236:Adenoma / Q000473:pathology / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery; D003537:Cystadenoma / Q000473:pathology / Q000601:surgery; D005260:Female; D006498:Hepatectomy; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D055815:Young Adult