Atypical Laparoscopic Resection in Benign Liver Tumors

I.D. Gerich, N.I. Boiko, I.Ya. Gavrysh, I.V. Kravchuk, M.P. Popyk, Yu.I. Shavarov

Abstract


The objective of this study was to assess the feasibility, safety, and outcome of laparoscopic liver resection for benign liver tumors.
Methods. Results of treatment of 6 patients with benign liver tumor lesions were analyzed retrospectively. From 2009 to 2013, 6 patients (1 male, 5 female; age 24–58 years; mean age 36.8 ± 12.1 years) with benign liver tumors underwent laparoscopic hepatic resections at our department. All patients were operated in the «French» position with a fourtrocars (rarely fivetrocars) configuration. Laparoscopy (30° video-camera) was performed under CO2 pneumoperitoneum (intraabdominal pressure — 15 mmHg). The transection of liver parenchyma was obtained by the use of a LigaSureTM. The Pringle manoeuvre was not used.
Results. Pathology included hemangioma (n = 2), hepatic angiomyolipoma (pecoma) (n = 1), hepatic focal nodular hyperplasia (n = 1), hepatic vascular malformations (n = 1), and hepatocellular adenoma (n = 1). Four (66.7 %) of these lesions were in the left liver (II, III, II–IV, II–III segments) and two (33.3 %) in the right lobe (V and VI segments). Mean tumour size was 65.0 ± 18.7 mm (range 50–89 mm). In 6 patients we performed 4 non-anatomical segmentectomy, I bisegmentectomy and I left lobectomy (including one patient with asymptomatic adenoma of the right adrenal gland — was performed simultaneous operation — right-sided laparoscopic adrenalectomy). The mean operative time was 105 ± 14 min (range 140–45). Mean blood loss was 50 ml and one patients (left lobectomy) after 400 ml of blood loss required blood transfusions.
There was no conversion to laparotomy for inadequate exposure, complications and operative or hospital mortality. The mean postoperative hospital stay was 8 ± 2 days (4–16 days). During permanent follow-up to date no recurrences at the site of resection or port-site complication have been observed.
Conclusion. Laparoscopic surgery for benign liver tumors is a promising direction to improve outcomes of surgical treatment of these patients, the success of which depends on the correct choice of indications, the combination of high technology and the necessary expertise in the field of hepatobiliary surgery and laparoscopic surgery.


Keywords


laparoscopy; resection of the liver; benign tumors; tumors of the liver

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DOI: https://doi.org/10.22141/1997-2938.3.22.2013.87326

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