Outcomes of Laparoscopic Liver Resection for Lesions Located in the Right Side of the Liver

Abstract

Hypothesis: Laparoscopic right-sided liver resection may be feasible and safe. Design: Retrospective analysis. Setting: Department of surgery at a university hospital. Patients: Of 103 consecutive laparoscopic liver resections performed from May 1, 2003, to April 30, 2007, 46 patients underwent a right-sided laparoscopic liver resection. Six operations required conversion (13%) to open surgery. Overall, data from 40 patients with benign liver tumors (n=2), intrahepatic duct stones (n=3), liver metastasis from colorectal cancer (n=8), and hepatocellular carcinomas (n=27) were analyzed. Main Outcome Measures: Feasibility and operative outcome. Results: The operations included 12 major resections (5 right hemihepatectomy and 7 right posterior sectionectomy) and 28 minor resections (14 segmentectomy and 14 tumorectomy). No operative mortality, subsequent operation, or life-threatening complications occurred. Overall, 11 patients (28%) experienced complications; 2 had bile leakage, 6 had perihepatic fluid collection, 2 had prolonged ascites, and 1 had pleural effusion. All recovered after conservative management. The mean operation time was 300 minutes, the mean blood loss was 620 mL, and the mean hospital stay was 11 days. For lesions located at segment VII or VIII (n=15), the mean operation time and amount of blood loss in those receiving a minor liver resection were similar to those who received a major resection (P=.21 and .88, respectively). Conclusion: Although greater technical refinement is required for a minor resection in the superior part of the right side of the liver, laparoscopic right-sided liver resection is feasible and safe.