Abstract
BackgroundLaparoscopic liver surgery is becoming increasingly common. This cohort study was designed to directly compare perioperative outcomes of the left lateral segmentectomy via laparoscopic and open approach.MethodsBetween 2002 and 2006 43 left lateral segmentectomies were performed at King's College Hospital. Those excluded from analysis included previous liver resections, polycystic liver disease, liver cirrhosis and synchronous operations. Of 20 patients analysed, laparoscopic (n = 10) were compared with open left lateral segmentectomy (n = 10). Both groups had similar patient characteristics.ResultsMorbidity rates were similar with no wound or chest infection in either group. The conversion rate was 10% (1/10). There was no difference in operating time between the groups (median time 220 minutes versus 179 minutes, p = 0.315). Surgical margins for all lesions were clear. Less postoperative opiate analgesics were required in the laparoscopic group (median 2 days versus 5 days, p = 0.005). The median postoperative in-hospital stay was less in the laparoscopic group (6 days vs 9 days, p = 0.005). There was no mortality.ConclusionLaparoscopic left lateral segmentectomy is safe and feasible. Laparoscopic patients may benefit from requiring less postoperative opiate analgesia and a shorter post-operative in-hospital stay.
Highlights
Laparoscopic liver surgery is becoming increasingly common
This resulted in 20 left lateral segmentectomies for comparison, 10 in the laparoscopic (LG) and 10 in the open group (OG)
Selection was based on referral to the individual consultants with all laparoscopic operations performed by a single surgeon (AGP) and open operations under the care of two surgeons (NH, MR)
Summary
Laparoscopic liver surgery is becoming increasingly common. This cohort study was designed to directly compare perioperative outcomes of the left lateral segmentectomy via laparoscopic and open approach. Laparoscopic enthusiasts have shown that it is safe and feasible to perform laparoscopic liver surgery [2,3,4,5]. Due to its anatomical accessibility left lateral segmentectomy (LLS) has been considered the training operation for all liver surgeons [6]. Proposed benefits of laparoscopic liver surgery include reduced overall blood loss, shorter hospital stay and less post-operative pain with a faster return to normal activity. To date one study has compared laparoscopic left lateral segmentectomy with an open approach using historical case controls [18]. The aim of this study was to undertake a contemporaneous comparison between laparoscopic and open left lateral segmentectomies
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