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Surgical management of benign and indeterminate hepatic lesions in the era of laparoscopic liver surgery

Surgical management of benign and indeterminate hepatic lesions in the era of laparoscopic liver surgery
Surgical management of benign and indeterminate hepatic lesions in the era of laparoscopic liver surgery
Background/Aims: 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.

Conclusion: 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.
0253-4886
232-236
Abu Hilal, Mohammed
384e1c60-8519-4eed-8e92-91775aad4c47
Di Fabio, Francesco
5318ae30-aac4-49ab-b11c-289ae2049cdf
Teng, Mabel Joey
4b5ab744-ed5c-4174-b2c8-1fc0b779d44a
Godfrey, Dean Anthony
e6b28e87-38d7-4b43-bdd3-dbab9dbe4903
Primrose, John Neil
d85f3b28-24c6-475f-955b-ec457a3f9185
Pearce, Neil William
12ab5ca5-a80c-4fe9-ab31-725048d6c747
Abu Hilal, Mohammed
384e1c60-8519-4eed-8e92-91775aad4c47
Di Fabio, Francesco
5318ae30-aac4-49ab-b11c-289ae2049cdf
Teng, Mabel Joey
4b5ab744-ed5c-4174-b2c8-1fc0b779d44a
Godfrey, Dean Anthony
e6b28e87-38d7-4b43-bdd3-dbab9dbe4903
Primrose, John Neil
d85f3b28-24c6-475f-955b-ec457a3f9185
Pearce, Neil William
12ab5ca5-a80c-4fe9-ab31-725048d6c747

Abu Hilal, Mohammed, Di Fabio, Francesco, Teng, Mabel Joey, Godfrey, Dean Anthony, Primrose, John Neil and Pearce, Neil William (2011) Surgical management of benign and indeterminate hepatic lesions in the era of laparoscopic liver surgery. Digestive Surgery, 28 (3), 232-236. (doi:10.1159/000321891). (PMID:21546776)

Record type: Article

Abstract

Background/Aims: 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.

Conclusion: 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.

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More information

Published date: 5 May 2011
Organisations: Cancer Sciences

Identifiers

Local EPrints ID: 350708
URI: https://eprints.soton.ac.uk/id/eprint/350708
ISSN: 0253-4886
PURE UUID: 5c02d2de-f3c1-4c38-a938-d7a99a2cf8ef
ORCID for John Neil Primrose: ORCID iD orcid.org/0000-0002-2069-7605

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Date deposited: 28 Mar 2013 15:43
Last modified: 16 Jun 2018 00:36

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Contributors

Author: Mohammed Abu Hilal
Author: Francesco Di Fabio
Author: Mabel Joey Teng
Author: Dean Anthony Godfrey
Author: Neil William Pearce

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