Laparoscopic Liver Resection in Patients with Previous Upper Abdominal Laparotomy

Abstract

Introduction: Laparoscopic Liver Resection (LLR) is now performed worldwide. However, LLR is sometimes difficult in patients with previous upper abdominal laparotomy. Methods: We did 78 LLRs in our institution from January 2012 to December 2019. In our cases, 7 patients were performed upper abdominal laparotomy previously. We did pure LLR and partial hepatetomy in the patients. We report the surgical outcomes of LLR in the patients. Results: The history of the upper abdominal surgery was as follows: gastrectomy in 2 cases, cholecystectomy in 1, and hepatectomy in 4. LLRs were performed for hepatocellular carcinoma in 5 cases and metastasis of gastro intestinal stromal tumor in 2. Their Child-Pugh Score was as follows: A in 5 cases and B in 2. There were no cases of conversion to open hepatectomy. Median intraoperative blood loss was 75ml and operative time was 151 minutes. Blood transfusion was performed in only one case. No postoperative complication was seen. Average duration postoperative hospital stay was 8 days. Conclusion: We investigated surgical outcome of LLR in patients with previous upper abdominal laparotomy. While our outcomes seems favorable and safety, further number of cases would be required to determine whether LLR is superior to open hepatectomy in patients with previous upper abdominal laparotomy.