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KMID : 0371320110800050334
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Journal of the Korean Surgical Society
2011 Volume.80 No. 5 p.334 ~ p.341
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Lessons learned from 100 initial cases of laparoscopic liver surgery
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Lee Mi-Ri
Kim Young-Hoon
Roh Young-Hoon
Oh Sung-Yong
Cho Jin-Han
Lee Jong-Hoon
Lee Sung-Wook
Roh Myung-Hwan
Jeong Jin-Sook
Han Sang-Young
Jung Ghap-Joong
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Abstract
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Purpose: Laparoscopic liver resection (LLR) is now widely accepted and is being increasingly performed. The present study describes our experience with LLR at a single center over an eight-year period.
Methods: This retrospective study enrolled 100 patients between October 2002 and February 2010. Forty-six benign lesions and 54 malignant lesions were included. The LLR performed included 58 pure laparoscopy procedures, 18 hand-assisted laparoscopy procedures and 24 hybrid technique procedures.
Results: The mean age of the patients was 57 years; among these patients, 31 were over 65 years of age. The mean operation time was 220 minutes. The overall morbidity was 11% and the mortality was zero. Among the 20 patients with simple hepatic cysts, 50% unexpectedly recurred. Among the 41 patients with hepatocellular carcinoma, 21 patients (51%) underwent preoperative radiofrequency ablation therapy or transarterial chemoembolization. During parenchymal-transection, 11 received blood transfusion. The width of the resection margins was under 0.5 cm in 11 cases (27%); 0.5 to 1 cm in 22 cases (54%) and over 1 cm in eight cases (12%). There was no port site seeding, but argon beam coagulation-induced tumor dissemination was observed in two cases. The overall two-year survival rate was 75%.
Conclusion: This study suggests that the applications for LLR can be gradually expanded when assuring that the safety and curability of LLR are equivalent to that of open liver resection.
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KEYWORD
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Laparoscopic liver resection, Hepatic cyst, Hapatocellular carcinoma, Resection margin
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