Key Technical Points And Clinical Analysis Of Laparoscopic Hepatectomy In 263 Patients

Objective:To describe our experiences on treating 263 patients by laparoscopic liver resection(LLR).Methods:From August 2008 to December 2016,a total of 263 patients with hepatic lesions were included in this retrospective study.Two groups(right liver group and left liver group:group R and group L)were divided based on the location of tumor.Clinical data,surgical procedures and post-hepatectomy outcomes during hospitalization were compared between 2 groups.Introduce our experiences on laparoscopic hepatectomy.Results:No significant difference on the clinical data was found between group R and group L.113 patients were performed with laparoscopic right side hepatectomy,142 with laparoscopic left side hepatectomy.The operative time and post-operative hospitalized days in the group R were significantly longer than those in the group L(154.63±67.84)min vs(131.12±59.45)min,P=0.041 for operative time;(11.05±4.33)d vs(8.95±4.61)d,P=0.007,P=0.003 for post-operative hospitalized days].Blood loss in the group R was significantly more than that in the group L(290.69±374.28)ml vs(141.61 ± 153.33)ml,P=0.003.Portal triad clamping rate was higher applied in the laparoscopic right liver resection.The levels of alanine aminotransferase(ALT)and aspartate aminotransferase(AST)were increased 1 day after LLR both in the two groups,and significant difference were observed.Conclusions:Our data suggest that laparoscopic liver resection was feasible and safe.Laparoscopic right hepatectomy may be more difficult than laparoscopic left hepatectomy,which is associated with longer operative time,post-operative hospitalized days,more blood loss,higher ALT and AST level.Advanced laparoscopic liver surgery such as laparoscopic major hepatectomy,laparoscopic caudate hepatectomy could be performed safely.