title: Laparoscopic liver resections in normal and cirrhotic livers: a retrospective analysis in a tertiary hepato-biliary unit.
abstract: BACKGROUND
  Liver surgery in patients with underlying liver disease results in higher mortality and morbidity rates compared to patients without underlying liver disease. Laparoscopy seems to have good results in patients with normal liver in terms of postoperative outcomes, but is more challenging in cirrhotic patients. Aim of this study was to evaluate the feasibility of laparoscopic liver resection both in normal and cirrhotic livers, and secondary endpoint was to compare the surgical results.
  
  
  METHODS
  We retrospectively evaluated 105 patients who underwent laparoscopic liver resection between November 2001 and January 2012. Candidates for laparoscopic liver resection were divided into two groups according to the presence or absence of an underlying liver disease.
  
  
  RESULTS
  105 patients (52.4% males, median age 56.1 years) were enrolled, and 37.1% had liver cirrhosis. Hepatocellular carcinoma in hepatitis C virus-related cirrhosis (89.7%) and liver metastases (57.6%) were the main indications for surgery in patients with cirrhosis and non-cirrhotic livers, respectively. None of the patients died post-operatively. Cirrhotic patients had greater blood loss (100 vs 50 ml; p<0.012) and longer hospital stays (6 vs 4 days; p<0.031) compared to non-cirrhotics.
  
  
  CONCLUSIONS
  Laparoscopic liver resections are safe and feasible procedures in both patients with cirrhotic and non-cirrhotic livers.
authors.affiliation: General Surgery and Transplantation Unit, S. Camillo Hospital, Rome, Italy. Electronic address: gmettorre@scamilloforlanini.rm.it.
authors.forename: Giuseppe Maria
authors.initials: GM
authors.lastname: Ettorre
authors.affiliation: General Surgery and Transplantation Unit, S. Camillo Hospital, Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Laurenzi
authors.affiliation: Hepatology and Infectious Disease Unit, National Institute for Infectious Disease "L. Spallanzani", Rome, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Lionetti
authors.affiliation: General Surgery and Transplantation Unit, S. Camillo Hospital, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Santoro
authors.affiliation: General Surgery and Transplantation Unit, S. Camillo Hospital, Rome, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Lepiane
authors.affiliation: General Surgery and Transplantation Unit, S. Camillo Hospital, Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Colasanti
authors.affiliation: General Surgery and Transplantation Unit, S. Camillo Hospital, Rome, Italy.
authors.forename: Lidia
authors.initials: L
authors.lastname: Colace
authors.affiliation: Department of Epidemiology and Pre-Clinical Research, National Institute for Infectious Disease "L. Spallanzani", Rome, Italy.
authors.forename: Pierluca
authors.initials: P
authors.lastname: Piselli
authors.affiliation: Hepato-Gastroenterology Unit, Marino General Hospital, Marino (Rome), Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Puoti
authors.affiliation: Hepatology and Infectious Disease Unit, National Institute for Infectious Disease "L. Spallanzani", Rome, Italy.
authors.forename: Gianpiero
authors.initials: G
authors.lastname: D'Offizi
authors.affiliation: Anesthesiology and Intensive Care Unit, National Institute for Infectious Disease "L. Spallanzani", Rome, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Antonini
authors.affiliation: General Surgery and Transplantation Unit, S. Camillo Hospital, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Vennarecci
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000601:surgery*; D016022:Case-Control Studies; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D019698:Hepatitis C, Chronic / Q000150:complications; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008103:Liver Cirrhosis / Q000150:complications*; D008113:Liver Neoplasms / Q000150:complications / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D016896:Treatment Outcome
keywords: Laparoscopic liver resections; Liver cirrhosis