BACKGROUND: An effort was made to evaluate the indications, safety, and therapeutic efficacy of laparoscopic liver surgery. METHODS: Between 1989 and 1996, 28 patients, 23 to 88 years old were operated upon laparoscopically. Pathology consisted of simple cyst (ten), polycystic liver disease (seven), hydatid cyst (three, two of them calcified), abscess (one), focal nodular hyperplasia (six), and metastatic breast cancer (one). RESULTS: Operations included 17 fenestrations, three pericystectomies, and eight resections (two lateral lobes). Operative time was 45 to 525 min with only four cases longer than 4 h. There was a 21% morbidity rate. There were no mortalities. Follow-up was 1-67 months with one asymptomatic recurrence. CONCLUSIONS: Laparoscopic hepatic surgery can be performed safely with good results by surgeons with hepatic and laparoscopic experience when careful selection criteria are followed. We advocate the "four-hands technique" for simultaneous dissection and control of bleeding and bile ducts during resections.
BACKGROUND: An effort was made to evaluate the indications, safety, and therapeutic efficacy of laparoscopic liver surgery. METHODS: Between 1989 and 1996, 28 patients, 23 to 88 years old were operated upon laparoscopically. Pathology consisted of simple cyst (ten), polycystic liver disease (seven), hydatid cyst (three, two of them calcified), abscess (one), focal nodular hyperplasia (six), and metastatic breast cancer (one). RESULTS: Operations included 17 fenestrations, three pericystectomies, and eight resections (two lateral lobes). Operative time was 45 to 525 min with only four cases longer than 4 h. There was a 21% morbidity rate. There were no mortalities. Follow-up was 1-67 months with one asymptomatic recurrence. CONCLUSIONS: Laparoscopic hepatic surgery can be performed safely with good results by surgeons with hepatic and laparoscopic experience when careful selection criteria are followed. We advocate the "four-hands technique" for simultaneous dissection and control of bleeding and bile ducts during resections.
Authors: Jean-François Gigot; David Glineur; Juan Santiago Azagra; Martine Goergen; Marc Ceuterick; Mario Morino; José Etienne; Jacques Marescaux; Didier Mutter; Ludo van Krunckelsven; Bernard Descottes; Dominique Valleix; François Lachachi; Claude Bertrand; Baudouin Mansvelt; Guy Hubens; Jean-Pierre Saey; Romain Schockmel Journal: Ann Surg Date: 2002-07 Impact factor: 12.969