Clinical Outcome of Liver Resection in Single Center Experience: Laparoscopic versus Open Procedure
- Pp. 87-98 (12)Toshimitsu Irei, Masahiro Tanemura, Masashi Inoue, Yosuke Shimizu, Harumi Tominaga and Nobutaka Hatanaka
Minimally invasive surgery for liver resection still remains controversial. The present study was designed to compare open versus laparoscopic liver resection (LLR).
Between January 2012 and December 2013, LLR was performed on 30 patients at our institution. We performed partial hepatectomy through a pure laparoscopic method and anatomical hepatectomy by a laparoscopy-assisted method. We performed a retrospective review of these patients.
The study comprised 25 men and 5 women with a mean age of 70.5 years. All patients had a liver function of Child-Turcott-Pugh classification A. The mean diameter of the tumors was 20.8 mm. Thirteen cases were resected by the pure method and 17 cases underwent the hybrid method. Nineteen patients underwent partial hepatectomy, 8 patients underwent subsegmentectomy, and 3 patients underwent segmentectomy. Mean intra-operative bleeding was 403.7 ml, and mean operating time was 316.4 min. No patients developed severe postoperative complications. We compared 19 laparoscopic partial hepatectomies (LLR-P) with 9 open partial hepatectomies. Although, no significant differences were observed in perioperative factors, both length of hospital stay and the frequency of analgesic administration were significantly reduced in LLR-P. Furthermore, we compared 13 laparoscopic (sub) segmentectomies (LLR-S) with 11 open cases. The operation time of LLR-S were longer than those of open cases, whereas no significant differences were detected in blood loss in these procedures. All length of hospital stay favored the LLR-S group.
In these series comparing laparoscopic and open liver resections, there were no severe complications observed in the LLR group and there was significant rapid recovery in the LLR group, even for resections involving (sub) segmentectomy by the hybrid method.