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01.05.2011 | Original Article | Ausgabe 5/2011

Journal of Gastrointestinal Surgery 5/2011

Single-Centre Comparative Study of Laparoscopic Versus Open Right Hepatectomy

Zeitschrift:
Journal of Gastrointestinal Surgery > Ausgabe 5/2011
Autoren:
Mohammed Abu Hilal, Francesco Di Fabio, Mabel Joey Teng, Pavlos Lykoudis, John Neil Primrose, Neil William Pearce
Wichtige Hinweise
Dr. Mohammed Abu Hilal and Dr. Francesco Di Fabio equally contributed to the scientific content of this paper.
Oral presentation, Annual Scientific Meeting of the Association of Laparoscopic Surgeons of Great Britain and Ireland, 25–26 November 2010, Nottingham, UK.

Abstract

Background

Expansion of laparoscopic major hepatectomy is still limited mainly due to the well-recognised technical difficulties compared to open surgery, and doubts regarding the oncological efficiency when major resections are required.

Methods

Patients undergoing open right hepatectomy (ORH) were matched with patients undergoing laparoscopic right hepatectomy (LRH) and compared for perioperative outcomes.

Results

Seventy patients were included: 36 patients underwent LRH and 34 ORH. Operative time was significantly longer for LRH (median, 300 min vs. 180 min for ORH; p < 0.0001). Intensive care unit (median, 2 days for LRH vs. 4 days for ORH; p < 0.0001) and postoperative length of stay (5 days for LRH vs. 9 days for ORH; p < 0.0001) were significantly shorter for LRH. Four laparoscopic cases were converted to open surgery. No significant difference in postoperative complications and mortality was observed between LRH and ORH. Among patients with colorectal carcinoma liver metastases, R0 resection was obtained in 20/21 (95%) cases after LRH, and in 20/25 (80%) after ORH (p = 0.198). Mid-term overall survival did not significantly differ between the laparoscopic and the open group.

Conclusions

LRH can be a safe, effective, and oncologically efficient alternative to open resection in selected cases. Extensive experience in hepatic and laparoscopic surgery is required.

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