Laparoscopic liver surgery program: An early experience from an Indian centre

Abstract

Introduction: Laparoscopic liver resection has evolved from being limited to benign conditions and minor resections to malignancies and major liver resections. Methods: Retrospective analysis of all laparoscopic liver resections for various indications at a tertiary referral teaching hospital. After the initial sporadic laparoscopic liver resections at our institute, 80 of the liver resections were performed after 2010. Duration, intraoperative blood loss and postoperative outcomes were recorded. Results: Of the 101 patients who underwent laparoscopic liver resections, 51 patients had gallbladder cancer (GBC) or suspected GBC, 20 patients had Hepatic hydatidosis, 14 cases had Hepatocellular carcinoma [HCC], besides others. Liver resections included 2 right hepatectomy, 3 left hepatectomy, 14 left lateral sectionectomy, 45segment IVb/V resections (as a part ofLaparoscopic radical cholecystectomy in 40 GBC and 5 suspected GBC cases), 14 cystopericystectomy and 23 nonanatomical/wedge resections. Laparoscopic liver wedge resection en bloc with gallbladder was done in 6 other cases with suspected GBC. Hydatid cysts were managed with laparoscopic total cystopericystectomy/resection in 14 cases and left lateral sectionectomy in 6 cases. In HCC, laparoscopic wedge resection was done in 9 cases and formal heaptectomy in 5 cases (1 right hepatectomy, 1 left hepatectomy, 3 left lateral sectionectomy). Five patients with hydatid cyst were converted due to technical difficulty and in two patients with GBC lymphadenectomy was done by open method. Conclusion: Laparoscopic liver resection is safe, feasible and is ableto achieve comparable clinical and oncological outcomes in selected patients.