Laparoscopic and hand-assisted liver resection: preliminary results at a mid-sized hospital

Laparoscopic liver resection is controversial, specially for tumors. The aim of our study is to report our initial experience.From October 2004 to October 2008, 15 patients underwent laparoscopic liver resection at our institution.Fifteen laparoscopic surgeries were performed on 15 patients. Five patients with hepatocellular carcinoma (HCC), six patients presented liver metastasis and four patients were diagnosed of hydatid cyst. In the HCC group two laparoscopic left lateral segmentectomies and 3 laparoscopic atypical resections were performed. Mean operative time was 230 minutes (95%CI 171-289). In the liver metastasis group six laparoscopic resections were performed. Two patients were converted to open surgery. The laparoscopic procedures were: 2 hand-assisted right hepatectomies, 1 left lateral segmentectomy and 1 atypical resection. The mean surgical time was 257.5 minutes, (95%CI 198-317). In the hydatid cyst group 4 laparoscopic surgeries were performed: three pericystectomies and one partial cystectomy. The mean operative time was 133.75 minutes, (95%CI 68-200). No re-operations were needed and no post-operative deaths occurred. In oncological resections surgical margins were free of tumor in all cases.When liver laparoscopic surgery is performed in selected patients, it may offer similar results to conventional surgery with all the benefits of the minimal invasive procedures.