Laparoscopic liver resections. Indications, technical aspects and results

Abstract

Background: laparoscopic hepatic resection is a topic of actuality among surgeons that treat hepatic diseases. These procedures have grown in a great way in different specialized centers, with favorable results for patients in the long and short term.
Objective: to evaluate the results obtained in our section of HPB surgery; to compare our current results with those of the initial series presented in 2007.
Methods: demographic characteristics; preoperative and postoperative diagnosis; resection indication; number, size and localization of lesions; performed procedure: pedicular clamping; parenchymal section technique; operative and clamping time, associated procedures, conversion ratio, hospital stay; morbidity and mortality; long term results in malignant tumors.
Results: 109 laparoscopic hepatic resections were performed in 100 patients, which represent 9% of hepatic resections at our hospital. 52% corresponded to benign tumors and 48% to malignant. 9 cases (9%) were converted to open surgery. There were 97 minor resections (89%) and 12 mayor resections (11%). In 26% of the patients, Pringle maneuver was done. Mean operative time was 177 minutes (30- 410). Mean hospital stay was 3 days (1-21). Only one patient died (1%) and 9 patients presented complications (9%). In all patients with malignant lesions a safe margin (R0) was achieved. The increase in laparoscopic resection of malignant tumors was statistically significant when compared with our initial publication. In cases of hepatic metastasis resection of colorectal cancer, the global survival rate and free of disease rate estimated to 1 -3 -5 years was 100% - 75% - 64% and 87% - 61%