Giuseppe Maria Ettorre1, Andrea Laurenzi2, Raffaella Lionetti3, Roberto Santoro2, Pasquale Lepiane2, Marco Colasanti2, Lidia Colace2, Pierluca Piselli4, Claudio Puoti5, Gianpiero D'Offizi3, Mario Antonini6, Giovanni Vennarecci2. 1. General Surgery and Transplantation Unit, S. Camillo Hospital, Rome, Italy. Electronic address: gmettorre@scamilloforlanini.rm.it. 2. General Surgery and Transplantation Unit, S. Camillo Hospital, Rome, Italy. 3. Hepatology and Infectious Disease Unit, National Institute for Infectious Disease "L. Spallanzani", Rome, Italy. 4. Department of Epidemiology and Pre-Clinical Research, National Institute for Infectious Disease "L. Spallanzani", Rome, Italy. 5. Hepato-Gastroenterology Unit, Marino General Hospital, Marino (Rome), Italy. 6. Anesthesiology and Intensive Care Unit, National Institute for Infectious Disease "L. Spallanzani", Rome, Italy.
Abstract
BACKGROUND: Liver surgery in patients with underlying liver disease results in higher mortality and morbidity rates compared to patients without underlying liver disease. Laparoscopy seems to have good results in patients with normal liver in terms of postoperative outcomes, but is more challenging in cirrhotic patients. Aim of this study was to evaluate the feasibility of laparoscopic liver resection both in normal and cirrhotic livers, and secondary endpoint was to compare the surgical results. METHODS: We retrospectively evaluated 105 patients who underwent laparoscopic liver resection between November 2001 and January 2012. Candidates for laparoscopic liver resection were divided into two groups according to the presence or absence of an underlying liver disease. RESULTS: 105 patients (52.4% males, median age 56.1 years) were enrolled, and 37.1% had liver cirrhosis. Hepatocellular carcinoma in hepatitis C virus-related cirrhosis (89.7%) and liver metastases (57.6%) were the main indications for surgery in patients with cirrhosis and non-cirrhotic livers, respectively. None of the patients died post-operatively. Cirrhotic patients had greater blood loss (100 vs 50 ml; p<0.012) and longer hospital stays (6 vs 4 days; p<0.031) compared to non-cirrhotics. CONCLUSIONS: Laparoscopic liver resections are safe and feasible procedures in both patients with cirrhotic and non-cirrhotic livers.
BACKGROUND: Liver surgery in patients with underlying liver disease results in higher mortality and morbidity rates compared to patients without underlying liver disease. Laparoscopy seems to have good results in patients with normal liver in terms of postoperative outcomes, but is more challenging in cirrhotic patients. Aim of this study was to evaluate the feasibility of laparoscopic liver resection both in normal and cirrhotic livers, and secondary endpoint was to compare the surgical results. METHODS: We retrospectively evaluated 105 patients who underwent laparoscopic liver resection between November 2001 and January 2012. Candidates for laparoscopic liver resection were divided into two groups according to the presence or absence of an underlying liver disease. RESULTS: 105 patients (52.4% males, median age 56.1 years) were enrolled, and 37.1% had liver cirrhosis. Hepatocellular carcinoma in hepatitis C virus-related cirrhosis (89.7%) and liver metastases (57.6%) were the main indications for surgery in patients with cirrhosis and non-cirrhotic livers, respectively. None of the patients died post-operatively. Cirrhotic patients had greater blood loss (100 vs 50 ml; p<0.012) and longer hospital stays (6 vs 4 days; p<0.031) compared to non-cirrhotics. CONCLUSIONS: Laparoscopic liver resections are safe and feasible procedures in both patients with cirrhotic and non-cirrhotic livers.
Authors: Antonio Giuliani; Luca Aldrighetti; Fabrizio Di Benedetto; Giuseppe Maria Ettorre; Paolo Bianco; Francesca Ratti; Giuseppe Tarantino; Roberto Santoro; Emanuele Felli Journal: Updates Surg Date: 2015-06-16
Authors: Giovanni Battista Levi Sandri; Edoardo de Werra; Gianluca Mascianà; Marco Colasanti; Roberto Santoro; Vito D'Andrea; Giuseppe Maria Ettorre Journal: Hepatobiliary Surg Nutr Date: 2016-12 Impact factor: 7.293
Authors: Emanuele Felli; Umberto Cillo; Antonio Daniele Pinna; Luciano De Carlis; Giorgio Ercolani; Roberto Santoro; Enrico Gringeri; Stefano Di Sandro; Marco Di Laudo; Michela Di Giunta; Andrea Lauterio; Marco Colasanti; Pasquale Lepiane; Giovanni Vennarecci; Giuseppe Maria Ettorre Journal: Updates Surg Date: 2015-07-25
Authors: Giovanni Battista Levi Sandri; Marco Colasanti; Roberto Santoro; Giuseppe Maria Ettorre Journal: Hepatobiliary Surg Nutr Date: 2015-12 Impact factor: 7.293
Authors: Giovanni Battista Levi Sandri; Lidia Colace; Giovanni Vennarecci; Roberto Santoro; Pasquale Lepiane; Marco Colasanti; Mirco Burocchi; Giuseppe Maria Ettorre Journal: Hepatobiliary Surg Nutr Date: 2015-10 Impact factor: 7.293