Tan To Cheung1. 1. Department of Surgery, The University of Hong Kong, Hong Kong, China.
Abstract
BACKGROUND: The advantages of laparoscopic liver resection become more obvious as evidence on its long-term outcome has emerged. Compared to open resection, there is no difference in term of overall survival. Many reports showed that the hospital stay was shorter and blood loss was less when laparoscopic hepatectomy was used. However, laparoscopic approach for caudate lobe resection remains a challenging procedure. The close proximity to inferior vena cava (IVC) and hepatic vein make this procedure extra difficult. This paper will demonstrate the use of pure laparoscopic approach for a patient with caudate lobe liver metastasis. Haemostasis by intracorporal suturing is safely performed when bleeding is encountered from the IVC. METHOD: The patient was a 54-year-old lady who had carcinoma of the rectum with laparoscopic anterior resection performed. She was found to have a 2 cm lesion in the left caudate lobe of the liver on follow-up. Her platelet count was only 120×109/L. Pure laparoscopic resection of the caudate lobe was performed as shown in the video. RESULTS: The operation last for 180 minutes. Blood loss was 220 mL and no blood transfusion was required. She resumed diet on the next day and was discharged 3 days after the operation. Histopathological examination showed 2 cm colorectal liver metastasis with a clear margin. Contrast CT scan performed 1 year after the operation showed no recurrence of the disease. CONCLUSIONS: Laparoscopic approach for caudate lobe resection is a feasible option. It can be performed to patients in center by surgeons with experience in both hepatobiliary and laparoscopic skills.
BACKGROUND: The advantages of laparoscopic liver resection become more obvious as evidence on its long-term outcome has emerged. Compared to open resection, there is no difference in term of overall survival. Many reports showed that the hospital stay was shorter and blood loss was less when laparoscopic hepatectomy was used. However, laparoscopic approach for caudate lobe resection remains a challenging procedure. The close proximity to inferior vena cava (IVC) and hepatic vein make this procedure extra difficult. This paper will demonstrate the use of pure laparoscopic approach for a patient with caudate lobe liver metastasis. Haemostasis by intracorporal suturing is safely performed when bleeding is encountered from the IVC. METHOD: The patient was a 54-year-old lady who had carcinoma of the rectum with laparoscopic anterior resection performed. She was found to have a 2 cm lesion in the left caudate lobe of the liver on follow-up. Her platelet count was only 120×109/L. Pure laparoscopic resection of the caudate lobe was performed as shown in the video. RESULTS: The operation last for 180 minutes. Blood loss was 220 mL and no blood transfusion was required. She resumed diet on the next day and was discharged 3 days after the operation. Histopathological examination showed 2 cm colorectal liver metastasis with a clear margin. Contrast CT scan performed 1 year after the operation showed no recurrence of the disease. CONCLUSIONS: Laparoscopic approach for caudate lobe resection is a feasible option. It can be performed to patients in center by surgeons with experience in both hepatobiliary and laparoscopic skills.
Authors: Tan To Cheung; Wai Key Yuen; Ronnie T P Poon; See Ching Chan; Sheung Tat Fan; Chung Mau Lo Journal: Hepatobiliary Pancreat Dis Int Date: 2014-04
Authors: Tan To Cheung; Ronnie T P Poon; Wai Key Yuen; Kenneth S H Chok; Caroline R Jenkins; See Ching Chan; Sheung Tat Fan; Chung Mau Lo Journal: Ann Surg Date: 2013-03 Impact factor: 12.969
Authors: Tan To Cheung; Ronnie T P Poon; Wai Key Yuen; Kenneth S H Chok; Simon H Y Tsang; Thomas Yau; See Ching Chan; Chung Mau Lo Journal: ANZ J Surg Date: 2012-10-04 Impact factor: 1.872
Authors: Tan To Cheung; Kelvin Kwok-chai Ng; Ronnie Tung-ping Poon; See Ching Chan; Chung Mau Lo; Sheung Tat Fan Journal: World J Gastroenterol Date: 2010-01-28 Impact factor: 5.742
Authors: Bin Jin; Zhengchen Jiang; Sanyuan Hu; Gang Du; Binyao Shi; Du Kong; Jinhuan Yang Journal: Biomed Res Int Date: 2018-01-16 Impact factor: 3.411