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Introduction The aim of this study was to estimate the immediate and long-term results of laparoscopic and robotic radical surgery for liver alveolar echinococcosis (AE). Methods From 2013 to 2019 6 patients with AE were undergone radically surgery using minimally invasive technologies. In 5 cases, a laparoscopic liver resection was performed, and in one case a Da'Vinci robotic complex was used. The average lesion size was 60 ± 20 mm. Results In three cases (50%) patients with P2 stage of the disease were operated on, in 3 cases with P1. In two cases, in patients with stage P2, a right hemihepatectomy was performed, in 2 cases a segmentectomy 8 with atypical resection segment 4 was performed, in one case a posterior sectionectomy was performed, in one case the intervention was performed with atypical resection of 6 segments. The average age of the patients was 55 years (27-79), three women and three men (1:1). The average size of the lesion was 60 ± 20 cm. The mean operation time and blood loss was 344 ± 141 minutes and 350 ± 333 mL. Complications were observed in one case (16.7%), type II according to Clavien-Dindo, represented by dynamic intestinal obstruction, which developed on the 6th day of the postoperative period and was resolved conservatively. Mean hospital stay was 9 ± 3. Conclusions Laparoscopic and robotic liver resections in the radical treatment of alveococcosis can be safe and feasible in the early stages of alveococcosis (P1-2H0M0), provided they are performed in a specialized hospital with sufficient technical equipment and an experienced surgeon.

Introduction Surgical resection in intrahepatic cholangiocarcinoma (IHCC) is the only feasible modality with a curative ability. The challenge balances between growing the future liver remnant (FLR) in a short time and the same time preventing tumor progression and surgical complications. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) gives a chance for fast kinetic growth, but with high morbidity and mortality. Methods This observation includes 8 comparative patients with IHCC: 4 underwent portal vein embolization (PVE) and 4, ALPPS (3, RALPPS). PVE group has median age 62.2 years, median FLR volume was 564.4 mL, 33%. ALPPS group has median age 58.6 years, median FLR volume was 542.6 mL, 34.9%. One patient had classic ALPPS and 3 had mini-invasive variant. Results The first stage was uncomplicated in the both groups. The median FLR volume became 785 mL (46%) in a 27.5 days and 753.9 mL (38%) in a 17.7 days in PVE and ALPPS groups respectively. Nevertheless, degree of hypertrophy was similar: 41% in PVE and 40.4% in ALPPS. Kinetic growth rate was significantly different: 1.38% and 2.62%/day, respectively. Seven patients completed the second stage. Sever morbidity was revealed with only ALPPS group: grade IIIa (n = 1) and grade V (n = 1) according to Clavien-Dindo. The in-hospital death was associated with classical ALPPS in one patient with extremely small FLR ( Conclusions The modified ALPPS (PRALPPS) may be considered as a safe tool to achieve rapid and sufficient hypertrophy in patients with IHCC.

Introduction The aim of the study was to compare the short- and long-term outcomes of laparoscopic liver resection (LLR) and open liver resection (OLR) for hepatocellular carcinoma (HCC) and to identify patients who might gain more benefits from LLR depending on tumor size. Methods The demographic and peri-operative data, short-term surgical outcomes, and long-term oncological results of 80 patients who received liver resection for HCC between January 2015 and December 2020 were analyzed (LLR, n=56; OLR, n=24). The average size of tumor in both groups were assessed for comparison. Results The average size of tumor was 50 mm in LLR and 80.3 mm in OLR. LLR is associated with less blood loss (p < 0.001), shorter length of hospital stay (p < 0.001), and lower morbidity rate (p = 0.034). The 5-year overall survival (OS) rates in the LLR group were significantly higher than those in the OLR group (81.3% vs. 27.5%; p = 0.020) and 5-year relapse free survival (55.1% vs 31.4%; p = 0.020). The short-term outcomes were better in the LLR group in terms of blood loss, and length of hospital stay, and these benefits attenuated with advancing tumor size. Conclusions LLR for HCC is a safe and feasible procedure that has better short-term and long-term oncological outcomes in patients with tumor size less than 50 mm.

Introduction The diffusion of laparoscopic radical surgery of hydatid liver echinococcosis remains limited. There no published data on a comparative analysis of the immediate and long-term results of radical and conservative laparoscopic surgery for liver hydatid cysts. Comparison of the immediate and long-term outcomes after laparoscopic radical and conservative cystectomies was aimed. Methods HPB center (center 1) and general surgery hospital in endemic area (center 2) participated in retrospective study. Radical surgery included total, subtotal pericystectomy and liver resection. Conservative surgery comprised cystectomy without/with partial pericystectomy. Results The total number of patients was 204. Laparoscopic cystectomy was performed in 97 (47%) patients. Radical (n-40) and conservative (n-61) laparoscopic procedures were performed in center 1 and center 2, respectively. Twenty-five pairs of patients were matched. The length of hospital stay and time of abdominal drainage were significantly shorter after radical surgery before and after PSM. The rate of severe morbidity did not differ. The mean follow-up length was 34 and 45 months in center 1 and center 2, respectively. No differences were found in the disease recurrence rate. Conclusions Laparoscopic radical surgery leads to a reduction in the treatment time and can be recommended as the preferred treatment option in a specialized HPB center.