Laparoscopic right hepatectomy: a challenging, but feasible, safe and efficient procedure

Pearce, Neil William, di Fabio, Francesco, Teng, Mabel Joey, Syed, Shareef, Primrose, John Neil and Abu Hilal, Mohammed (2011) Laparoscopic right hepatectomy: a challenging, but feasible, safe and efficient procedure. The American Journal of Surgery, 202 (5), e52-e58. (doi:10.1016/j.amjsurg.2010.08.032). (PMID:21861979)

Abstract

BACKGROUND: Few centers are undertaking major laparoscopic liver resections, because of the well-recognized technical difficulties and lack of training opportunities.

METHODS: The authors describe their technique for laparoscopic right hepatectomy, highlighting relevant details for accomplishing a safe and efficient procedure. Patients were chronologically divided into 2 groups to evaluate the impact of increasing experience on the surgical outcomes.

RESULTS: Group I included 17 patients and group II 18 patients. The conversion rate to open or hybrid techniques significantly decreased from 36% in group I to 6% in group II (P = .03). The hospital stay decreased from a median of 6 days in group I to a median of 4 days in group II (P = .05). Complications occurred in 4 patients (11%), of whom 3 were in group I. The mortality was zero.

CONCLUSIONS: Laparoscopic right hepatectomy is a safe and efficient procedure when performed at specialized centers with extensive experience in hepatic surgery. Long-term training is necessary to acquire adequate expertise.

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Contributors

Author: John Neil Primrose

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