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

Am J Surg. 2011 Nov;202(5):e52-8. doi: 10.1016/j.amjsurg.2010.08.032. Epub 2011 Aug 20.

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.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Loss, Surgical
  • Clinical Competence*
  • Female
  • Hepatectomy / methods*
  • Humans
  • Laparoscopy*
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Postoperative Complications