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Laparoscopic versus open left lateral segmentectomy.

Carswell KA, Sagias FG, Murgatroyd B, Rela M, Heaton N, Patel AG - BMC Surg (2009)

Bottom Line: The conversion rate was 10% (1/10).Surgical margins for all lesions were clear.There was no mortality.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institute of Liver Studies, King's College Hospital, London, UK. kirstincarswell@hotmail.com

ABSTRACT

Background: 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.

Methods: Between 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.

Results: Morbidity 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.

Conclusion: Laparoscopic 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.

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Related in: MedlinePlus

Trocar placement for laparoscopic left lateral segmentectomy. For extraction a pfannenstiel incision is usually used.
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Figure 2: Trocar placement for laparoscopic left lateral segmentectomy. For extraction a pfannenstiel incision is usually used.

Mentions: The initial port location varied depending upon previous surgery. Intra-abdominal pressure was kept at approximately 15 mmHg. Four additional ports were inserted (figure 2). A 30° laparoscope was used. The falciform and left triangular ligament was divided using a harmonic scalpel (Ethicon, Endo-Surgery Inc. Cincinnati Ohio). The falciform ligament was used to retract and manipulate the left lobe of the liver.


Laparoscopic versus open left lateral segmentectomy.

Carswell KA, Sagias FG, Murgatroyd B, Rela M, Heaton N, Patel AG - BMC Surg (2009)

Trocar placement for laparoscopic left lateral segmentectomy. For extraction a pfannenstiel incision is usually used.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2742511&req=5

Figure 2: Trocar placement for laparoscopic left lateral segmentectomy. For extraction a pfannenstiel incision is usually used.
Mentions: The initial port location varied depending upon previous surgery. Intra-abdominal pressure was kept at approximately 15 mmHg. Four additional ports were inserted (figure 2). A 30° laparoscope was used. The falciform and left triangular ligament was divided using a harmonic scalpel (Ethicon, Endo-Surgery Inc. Cincinnati Ohio). The falciform ligament was used to retract and manipulate the left lobe of the liver.

Bottom Line: The conversion rate was 10% (1/10).Surgical margins for all lesions were clear.There was no mortality.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institute of Liver Studies, King's College Hospital, London, UK. kirstincarswell@hotmail.com

ABSTRACT

Background: 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.

Methods: Between 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.

Results: Morbidity 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.

Conclusion: Laparoscopic 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.

Show MeSH
Related in: MedlinePlus