Laparoscopic anatomical right hemihepatectomy through the right incisura or the right groove

Abstract

Objective To evaluate laparoscopic right hepatectomy through the right incisura or the right groove for hepatic benign disease. Methods This study enrolled 32 patients of hepatic benign lesions within the right lobe of the liver including hepatic hemangioma (n=7), hepatic focal nodular hyperplasia (n=2), right intra-hepatic bile duct stones (n=23) with concomitant extra-hepatic bile duct stones in 19 cases. Results Laparoscopic procedures were successful in 28 patients, while 4 patients were converted to laparotomy. Time of operation was 235 to 405 min, time for right hemihepatectomy was (305±41) min on average. Time for right hemihepatectomy and biliary tract exploration and removal of stones was (326±48) min on average. The intraoperative blood loss was (573±219) ml on average. On postoperative follow-up, patients with hepatic hemangioma and focal nodular hyperplasia had no residual lesions. 2 cases suffered calculus residue, residual stones were removed by repeat choledochoscopy with primary stones clearence rate of 91.3% (21/23). Bile leakage occurred in 3 cases and pleural effusion in 7 cases. The gastrointestinal function recovered (2.8±0.71) days after surgery. The hospital stay was (11.5±2.98) days. 28 patients were followed up for (32±8) months. Conclusion The laparoscopic anatomical right hemihepatectomy through the right incisura or the right groove is a satisfactory surgical procedure. Key words: Hepatectomy; Laparoscopes; Liver benign diseases