Indications for open left lateral sectionectomy in the Era of laparoscopic liver surgery

AbstractThe aim of the study was to evaluate the possibility to use live anesthetized pigs as a model for laparoscopic liver resection. During two days laparoscopy course two trainees were operating on two live animals performing exposure of the liver, Pringle manoeuver, division of liver ligaments, dissecting of the structures inside the hepatoduodenal ligament, dissection of the hepatic veins and left lateral liver sectionectomy. Exposure of the liver and Pringle manoeuver were performed correctly within 50 and 35 minutes. Left lateral sectionectomy has been performed correctly within 2 hours. The full dissection of the hepatoduodenal ligament and exposure of the hepatic veins were judged as insufficient by experienced laparoscopic tutors. There was one injury to the suprahepatic vena cava that was managed laparoscopically. The porcine model can be used as an advanced training for laparoscopic liver surgery.

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Laparoscopic hepatic left lateral sectionectomy using the LaparoEndoscopic Single Site approach: evolution of minimally invasive liver surgery

Journal of Hepato-Biliary-Pancreatic Sciences ◽

10.1007/s00534-010-0280-6 ◽

2010 ◽

Vol 18 (1) ◽

pp. 103-105 ◽

Cited By ~ 39

Author(s):

Luca Aldrighetti ◽

Eleonora Guzzetti ◽

Gianfranco Ferla

Keyword(s):

Minimally Invasive ◽

Liver Surgery ◽

Single Site ◽

Left Lateral Sectionectomy ◽

Minimally Invasive Liver Surgery ◽

Laparoendoscopic Single Site ◽

Lateral Sectionectomy

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Operative Time, Age, and Serum Albumin Predict Surgical Morbidity After Laparoscopic Liver Surgery

Surgical Innovation ◽

10.1177/1553350621991223 ◽

2021 ◽

pp. 155335062199122

Author(s):

Daniel Heise ◽

Jan Bednarsch ◽

Andreas Kroh ◽

Sandra Schipper ◽

Roman Eickhoff ◽

...

Keyword(s):

Liver Resection ◽

Liver Surgery ◽

Postoperative Morbidity ◽

Operative Time ◽

Multivariable Analysis ◽

Operation Time ◽

Laparoscopic Liver Surgery ◽

Surgical Morbidity ◽

Perioperative Morbidity ◽

Preoperative Albumin

Background. Laparoscopic liver resection (LLR) has emerged as a considerable alternative to conventional liver surgery. However, the increasing complexity of liver resection raises the incidence of postoperative complications. The aim of this study was to identify risk factors for postoperative morbidity in a monocentric cohort of patients undergoing LLR. Methods. All consecutive patients who underwent LLR between 2015 and 2019 at our institution were analyzed for associations between complications with demographics and clinical and operative characteristics by multivariable logistic regression analyses. Results. Our cohort comprised 156 patients who underwent LLR with a mean age of 60.0 ± 14.4 years. General complications and major perioperative morbidity were observed in 19.9% and 9.6% of the patients, respectively. Multivariable analysis identified age>65 years (HR = 2.56; P = .028) and operation time>180 minutes (HR = 4.44; P = .001) as significant predictors of general complications (Clavien ≥1), while albumin<4.3 g/dl (HR = 3.66; P = .033) and also operative time (HR = 23.72; P = .003) were identified as predictors of major postoperative morbidity (Clavien ≥3). Conclusion. Surgical morbidity is based on patient- (age and preoperative albumin) and procedure-related (operative time) characteristics. Careful patient selection is key to improve postoperative outcomes after LLR.

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