Background
Laparoscopic liver resection is usually limited to the anterolateral segments of the
liver (AL; Segments II, III, V, VI, and the inferior part of IV). We evaluated the
feasibility of laparoscopic liver resection in the posterosuperior segments (PS; Segments
I, VII, VIII, and the superior part of IV).
Method
We analyzed retrospectively the clinical data of 82 patients who underwent laparoscopic
liver resection for tumors from September 2003 to September 2007. Patients were classified
into 2 groups according to tumor location: group AL (n=54) and group PS (n=28).
Results
There was no mortality, reoperation, or major complications. Four (5%) conversions
to open procedures were necessary. There were no differences in tumor characteristics,
including mean tumor size and number of tumors between 2 groups (P = .427 and .611); however, there was a greater proportion of deeply seated tumors
in group PS than group AL (P < .001). The predominant type of resection was a minor liver resection (left lateral
sectionectomy, segmentectomy, or tumorectomy) in group AL, and a major liver resection
(hemihepatectomy or right posterior sectionectomy) in group PS (P < .001). The median operative time in group PS was greater than that in group AL
(320 vs 210min; P < .001). There were no differences in the conversion rate (P = .113), median blood loss (P = .214), rate of intraoperative transfusion (P = .061), median tumor-free margin (P = .613), median hospital stay (P = .166), and rate of complications (P = .148) between the 2 groups.
Conclusion
Laparoscopic liver resection for tumors located in PS is more difficult than in AL
but is feasible in selected patients.
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Article info
Publication history
Published online: May 12, 2008
Accepted:
March 24,
2008
Identification
Copyright
© 2008 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
