| Author/Editor | Ivanecz, Arpad; Plahuta, Irena; Magdalenić, Tomislav; Jagrič, Tomaž; Krebs, Bojan | |
| Title | Prevention of complications related to laparoscopic liver resection | |
| Type | članek | |
| Vol. and No. | Letnik 2, št. 1 | |
| Publication year | 2020 | |
| Volume | str. 7-12 | |
| ISSN | 2591-2275 | |
| Language | eng | |
| Abstract | Background. Laparoscopic liver resection (LLR) has been ac-cepted as an attractive alternative to open liver resection. In determining the appropriateness of a minimally invasive ap-proach, the primary consideration is patient safety. This study analyzes complications related to LLR.Methods. A prospectively maintained database of all consecutive LLRs in a tertiary referral center specializing in hepa-to-pancreato-biliary surgery was retrospectively reviewed. The first 128 patients that underwent pure LLRs between April 2008 and February 2019 were analyzed. Intraoperative complications were defined as major blood loss, unintentional damage to surrounding structures, and conversion to an open approach. Post-operative complications were defined and graded according to the Clavien-Dindo classification.Results. Altogether, 23 of the 128 LLR procedures (17.9%) were associated with intraoperative complications. Median estimated blood loss was 110 ml (range: 0-2,200 ml). Seventeen (13.2%) patients received perioperative blood transfusion. Blood loss of more than 775 ml occurred in eight (6.2%) patients (conversion to laparotomy was required in three of them). No unintention-al damage to surrounding structures occurred in any patients. Conversion to laparotomy was required in 18 (14.0%) patients. The overall incidence of postoperative complications was 38 (29.7%). The incidence of postoperative major morbidity and mortality were 9.3% (n = 12) and 0.8% (n = 1), respectively. Four patients (3.1%) required reoperations. Three patients (2.3%) were readmitted after discharge from the hospital.Conclusion. Only the subset of surgeons that are dually trained in hepatobiliary surgery and minimally invasive surgery are adequately equipped to safely perform LLR. Surgeons should recognize the increased risk they assume by taking on more com-plex procedures. | |
| Keywords | liver resection morbidity mortality resekcija jeter obolevnost umrljivost |