Laparoscopic liver resection for XXXX : preliminary results of a multicenter European study.

@entity1 @entity96 @entity5 @entity409 @entity260 @entity3 @entity14 @entity157
OBJECTIVE: To assess the feasibility, safety, and outcome of laparoscopic liver resection for @entity96 . SUMMARY BACKGROUND DATA: The precise role of laparoscopy in resection of @entity409 ( @entity157 [ @entity157 ] and liver @entity3 ) remains controversial despite an increasing number of publications reporting laparoscopic resection of @entity96 . METHODS: A retrospective study was performed in 11 surgical centers in Europe regarding their experience with laparoscopic resection of @entity409 . Detailed questionnaires were sent to each surgeon focusing on @entity1 characteristics, clinical data, type and characteristics of the @entity5 , technical details of the operation, and early and late clinical outcome. All @entity1 had radiologic investigations at follow-up to exclude disease recurrence. RESULTS: From February 1994 to December 2000, 37 @entity1 with @entity96 were included in this study. Ten @entity1 had @entity157 , including 9 with cirrhotic liver, and 27 @entity1 had liver @entity3 . The mean @entity5 size was 3.3 cm, and 89% of the @entity5 were located in the left lobe or in the anterior segments of the right liver. Liver procedures included 12 wedge resections, 9 segmentectomies, 14 bisegmentectomies (including 13 left lateral segmentectomies), and 2 major hepatectomies. The transfusion rate, the use of pedicular clamping, the conversion rate (13.5% in the whole series), and the complication rate were significantly greater in @entity1 with @entity157 . There were no deaths. @entity260 occurred in eight @entity1 (22%). The surgical margin was less than 1 cm in 30% of the @entity1 . During a mean follow-up of 14 months, the 2-year disease-free survival was 44% for @entity1 with @entity157 and 53% for @entity1 having hepatic @entity3 from @entity14 . No port-site @entity3 were observed during follow-up. CONCLUSIONS: In @entity1 with small @entity5 , located in the left lateral segments or in the anterior segments of the right liver, laparoscopic resection is feasible and safe. The complication rate is low, except in @entity1 with @entity157 on cirrhotic liver. By using laparoscopic ultrasound, a 1-cm free surgical margin should be routinely obtained. The late outcome needs to be evaluated in expert centers.
