This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Laparoscopic liver resection. BJS 2006; 93: 67-72.

Published: 4th November 2005

Authors: E. Vibert, T. Perniceni, H. Levard, C. Denet, N. K. Shahri, B. Gayet et al.

Background

This paper describes a 10‐year experience of laparoscopic liver surgery, including several major hepatectomies for malignant tumours.

Method

Of 243 hepatectomies carried out between January 1995 and December 2004, 113 (46·5 per cent) were performed by laparoscopy and 89 were included in this retrospective study.

Results

Twenty‐four laparoscopic hepatectomies (27 per cent) were for benign disease and 65 (73 per cent) for malignant tumours, including hepatocellular carcinoma (HCC) in 16 patients and colorectal metastasis (CRM) in 41. Minor hepatectomy was performed in 51 patients and major hepatectomy (three or more Couinaud segments) in 38. Conversion to laparotomy was necessary in 12 patients and perioperative blood transfusion in eight. One patient with cirrhosis who underwent right hepatectomy for HCC with conversion to open surgery died 8 days after surgery. Major morbidity occurred in eight patients (16 per cent) having minor hepatectomy and in 11 (29 per cent) of those having a major resection. The 3‐year overall and disease‐free survival rates for patients with CRM (mean follow‐up 30 months) were 87 (11 patients at risk) and 51 (6 patients at risk) per cent respectively. Corresponding values for patients with HCC (mean follow‐up 40 months) were 85 (10 patients at risk) and 68 (5 patients at risk) per cent.

Conclusion

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