Introduction: Laparoscopic liver resection (LLR) of solid liver tumors (SLT) has not become widespread due to technical problems, the risk of air embolism, and possible tumoral spread in malignant lesions. We present our experience of LLR in SLT.
Patients and method: Between January 2003 and May 2005, we performed the laparoscopic approach in 16 patients with SLT. Preoperative diagnosis was liver metastases from colorectal carcinoma in 11 patients and benign tumor in the remaining five patients. Five of the lesions were located in the left lobe, another 10 in the right lobe (two in S. V, four in S. VI and four in S. VII) and the remaining lesion was bilobar (S. III and VI). LLRs were performed by complete laparoscopic hepatectomy (CLH) (n=8) and assisted laparoscopic hepatectomy (ALH) (n=8). LLR was completed in 13 patients (81%). Surgical technique (n=13) consisted of three left lobectomies, one with partial resection of S. IV, three bisegmentectomies (two of S. VI and VII and one of S. III and IV, the latter associated with metastasectomy in S. VIII), five segmentectomies (one of S. II, two of S. V and two of S. VI, one of the latter associated with metastasectomy in S. VII) and two local resections of benign tumors.
Results: There was no intra- or postoperative mortality. With CLH the LLR was completed in five patients (62%), whereas with ALH there were no conversions. Only one of the 13 resected patients required transfusion. Seventeen nodules were excised in the 13 LLR, and 12 of 17 required the Pringle maneuver. The mean length of hospital stay was 4.9 days (3-14 days). Only one female patient (7.7%) developed an infected hematoma, requiring radiological drainage.
Conclusion: LLR of benign SLTs shows all the advantages of laparoscopy. In the case of malignant lesions, greater experience is needed to confirm the safety and effectiveness of the open approach.