Feasibility And Generalized Application Of Laparoscopic Left Lateral Liver Sectionectomy

Purpose:Discuss the feasibility and generalized application of laparoscopic left lateral liver sectionectomy through comparing the differences of perioperative index, postoperative clinical follow-up between laparoscopic left lateral liver sectionectomy (LLLS) and open lateral liver sectionectomy(OLLS), analyse the indications, advantages and limitations, liver function changes of perioperative period and identify the standard indications and contraindications for laparoscopic left lateral sectionectomy.Methods:Through the retrospective analysis of cases of patient performed laparoscopic and open left lateral liver sectionectomy for hepatocellular carcinoma, cavernous hemangioma of liver, hepatolithiasis between January2010and September2013at Qilu Hospital of Shandong University, collect the data including the gender the age, the function of liver before and after the operation, length of operation, blood loss and transfusion during operation, complications, histological type, follow up them by telephone, outpatient service, then analyze their differences statistically.Results:Retrospectively analyzing23cases of patient performed LLLS and22cases performed OLLS during January2010and September2013at Qilu Hospital of Shandong University, there are27male cases and18female cases with age vary from30to65. Ultrasonic scalpel and Endo-GIA were used in LLLS and clamp method anatomical hepatoectomy in OLLS. There are41cases with Child-pugh class A liver function and4with Child-pugh class B.22case performed LLLS were in Child-pugh class A, and the other one was in Child-pugh class B. All OLLS were performed successfully, one in LLLS was conversion to open surgery.24cases was detected hepatocellular carcinoma,20cases were detected cavernous hemangioma, and one was detected hepatolithiasis pathologically. The mean hospital stay were13.7±0.5days, the mean operation time were126.4±9.9mins, the mean blood loss was104.1±23.0ml. There were no complications during and after the operation. Comparing the OLLS, there are statistically significant differences in hospital stay, operation time, and blood loss.Conclusion:Now the LLLS is strongly advised to patients with liver function above Child-Pugh class B. Comparing the OLLS the study demonstrates advantages in smaller lesions, less complications and blood loss with applications on both benign and malignant tumors. The effectiveness with LLLS approximate OLLS with skillfully operation technique of open surgery and laparoscopical skills. The standard of indications is needing deep discussion for further uses.