Clinical Study Of Laparoscopic Left Hemihepatectomy

Background:Laparoscopic liver resection were performed in some institutes. Procedure mainly included local resection, segmentectomy and left later segmentectomy. With experience accumulation and technique innovation, laparoscopic left hemihepatectomy was performed on selected patients. The aim of this study was to introduce this procedure and evaluate the safety and feasibility of this procedure.Methods:Nineteen successive patients underwent laparoscopic left hemihepatectomy from 2005 to 2007. They were compared with other 19 patients who underwent conventional open left hemihepatectomy by matched-pair method. Surgical feature, postoperative course, and the learning curve of laparoscopic left hemihepatectomy were studied.Results:Laparoscopic hemihepatectomy was successfully performed on 17 patients. Two conversions were required. As compared with open group, the blood loss was much less in laparoscopic group (462±372ml versus 895±704ml, p=0.03). Postoperative hospital stay of laparoscopic group was shorter but no significant than open group (9±5d versus 13±7d, p=0.086). Postoperative albumin level of laparoscopic group is significantly higher than open group (33.0±4.8g/L versus 27.6±3.2g/L, P=0.001). There was no perioperative mortality in both group. Two complications occurred in laparoscopic group (11%) and four in open group (21%). A tendency of gradually decreased transecting time was noticed in the early cases (R2=0.676, p=0.012). Conclusions:Laparoscopic left hemihepatectomy is a safe and feasible procedure in the selected patients.