title: Pure laparoscopic hepatectomy as repeat surgery and repeat hepatectomy.
abstract: OBJECTIVE
  To assess clinical outcomes of laparoscopic hepatectomy (LH) in patients with a history of upper abdominal surgery and repeat hepatectomy.
  
  
  METHODS
  This study compared the perioperative courses of patients receiving LH at our institution that had or had not previously undergone upper abdominal surgery. Of the 80 patients who underwent LH, 22 had prior abdominal surgeries, including hepatectomy (n = 12), pancreatectomy (n = 3), cholecystectomy and common bile duct excision (n = 1), splenectomy (n = 1), total gastrectomy (n = 1), colectomy with the involvement of transverse colon (n = 3), and extended hysterectomy with extensive lymph-node dissection up to the upper abdomen (n = 1). Clinical indicators including operating time, blood loss, hospital stay, and morbidity were compared among the groups.
  
  
  RESULTS
  Eighteen of the 22 patients who had undergone previous surgery had severe adhesions in the area around the liver. However, there were no conversions to laparotomy in this group. In the 58 patients without a history of upper abdominal surgery, the median operative time was 301 min and blood loss was 150 mL. In patients with upper abdominal surgical history or repeat hepatectomy, the operative times were 351 and 301 min, and blood loss was 100 and 50 mL, respectively. The median postoperative stay was 17, 13 and 12 d for patients with no history of upper abdominal surgery, patients with a history, and patients with repeat hepatectomy, respectively. There were five cases with complications in the group with no surgical history, compared to only one case in the group with a prior history. There were no statistically significant differences in the perioperative results between the groups with and without upper abdominal surgical history, or with repeat hepatectomy.
  
  
  CONCLUSIONS
  LH is feasible and safe in patients with a history of upper abdominal surgery or repeat hepatectomy.
authors.affiliation: Masashi Isetani, Zenichi Morise, Norihiko Kawabe, Hirokazu Tomishige, Hidetoshi Nagata, Jin Kawase, Satoshi Arakawa, Department of Surgery, Fujita Health University School of Medicine, Banbuntane Houtokukai Hospital, Aichi, Nagoya 454-8509, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Isetani
authors.affiliation: Masashi Isetani, Zenichi Morise, Norihiko Kawabe, Hirokazu Tomishige, Hidetoshi Nagata, Jin Kawase, Satoshi Arakawa, Department of Surgery, Fujita Health University School of Medicine, Banbuntane Houtokukai Hospital, Aichi, Nagoya 454-8509, Japan.
authors.forename: Zenichi
authors.initials: Z
authors.lastname: Morise
authors.affiliation: Masashi Isetani, Zenichi Morise, Norihiko Kawabe, Hirokazu Tomishige, Hidetoshi Nagata, Jin Kawase, Satoshi Arakawa, Department of Surgery, Fujita Health University School of Medicine, Banbuntane Houtokukai Hospital, Aichi, Nagoya 454-8509, Japan.
authors.forename: Norihiko
authors.initials: N
authors.lastname: Kawabe
authors.affiliation: Masashi Isetani, Zenichi Morise, Norihiko Kawabe, Hirokazu Tomishige, Hidetoshi Nagata, Jin Kawase, Satoshi Arakawa, Department of Surgery, Fujita Health University School of Medicine, Banbuntane Houtokukai Hospital, Aichi, Nagoya 454-8509, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Tomishige
authors.affiliation: Masashi Isetani, Zenichi Morise, Norihiko Kawabe, Hirokazu Tomishige, Hidetoshi Nagata, Jin Kawase, Satoshi Arakawa, Department of Surgery, Fujita Health University School of Medicine, Banbuntane Houtokukai Hospital, Aichi, Nagoya 454-8509, Japan.
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Nagata
authors.affiliation: Masashi Isetani, Zenichi Morise, Norihiko Kawabe, Hirokazu Tomishige, Hidetoshi Nagata, Jin Kawase, Satoshi Arakawa, Department of Surgery, Fujita Health University School of Medicine, Banbuntane Houtokukai Hospital, Aichi, Nagoya 454-8509, Japan.
authors.forename: Jin
authors.initials: J
authors.lastname: Kawase
authors.affiliation: Masashi Isetani, Zenichi Morise, Norihiko Kawabe, Hirokazu Tomishige, Hidetoshi Nagata, Jin Kawase, Satoshi Arakawa, Department of Surgery, Fujita Health University School of Medicine, Banbuntane Houtokukai Hospital, Aichi, Nagoya 454-8509, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Arakawa
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D005240:Feasibility Studies; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007564:Japan; D010535:Laparoscopy / Q000009:adverse effects; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010532:Peritoneal Diseases / Q000175:diagnosis / Q000209:etiology*; D011183:Postoperative Complications / Q000209:etiology; D012086:Reoperation; D013997:Time Factors; D000267:Tissue Adhesions; D016896:Treatment Outcome
keywords: Chronic liver disease; Laparoscopic hepatectomy; Liver tumor; Repeat hepatectomy; Surgical history