[Laparoscopic liver resection : A retrospective analysis of 94 clinical cases]. / Laparoskopische Leberresektion : Eine retrospektive Analyse von 94 klinischen Fällen.

ABSTRACT

BACKGROUND: Since the introduction of minimally invasive surgery its use in liver resections is controversial. The importance of laparoscopic liver surgery within a large collective has been studied insufficiently to date. OBJECTIVES: In this article we report our experiences with minimally invasive liver resections. METHODS: A retrospective analysis was conducted looking at all patients in our clinic where a laparoscopic liver resection was performed between 01 January 2000 and 30 April 2013. RESULTS: In total, we performed 94 laparoscopic liver resections in 90 patients (female n = 44, 46.8 %, male n = 50, 53.2 %) with 28 primary and 63 secondary liver tumors and 3 tumors remaining unclear. Of these 62 were atypical or wedge resections, 19 segmental resections, 8, left lateral and 3 right lateral resections as well as 1 hemihepatectomy left and 1 right. Switching to an open resection intraoperatively was necessary in eight cases. Postoperative complications were observed in two patients, one patient experienced a postoperative cerebral artery stroke and one patient died on postoperative day 13 from sepsis in multiorgan failure. The average operative time was 145 ± 82.34 min (range 10-430 min) and the average hospital stay 7 days. In 79 patients an R0 resection was achieved. CONCLUSIONS: Laparoscopic liver resection can be considered a safe procedure for the treatment of liver tumors. The accurate selection of patients and appropriate expertise of the attending team in minimally invasive surgery are essential to the outcome.