NDLI: Evaluation of a laparoscopic liver resection in the setting of cirrhosis.

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Evaluation of a laparoscopic liver resection in the setting of cirrhosis.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Cannon, Robert M. Saggi, Bob Buell, Joseph F.
Description	Country affiliation: United States Author Affiliation: Cannon RM ( Deparment of Surgery, University of Louisville, Louisville, KY, USA.)
Abstract	INTRODUCTION: Patients presenting with cirrhosis and hepatic tumours represent a fragile group that have typically been avoided in early series of laparoscopic liver resection. This study was undertaken to evaluate the results of a laparoscopic hepatectomy in the setting of cirrhosis. METHODS: Subgroup analysis of patients with cirrhosis within a series of 327 patients undergoing a laparoscopic resection was performed. Comparisons were made with patients without cirrhosis where appropriate to highlight differences in patient selection and outcomes. Specific variables assessed included operative details and short-term outcomes including length of stay (LOS), morbidity and mortality. Outcomes specific to hepatocellular carcinoma (HCC) were also assessed. RESULTS: There were 52 patients with cirrhosis undergoing a laparoscopic hepatic resection. Ninety per cent of patients were Childs class A, with a median model for end-stage liver disease (MELD) score of 8. Hepatitis C was the most common cause of cirrhosis (88.5%), whereas the most common indication for an operation was HCC (71.2%). Resections were generally limited, with the median number of segments resected being 2 (range: 1-4). Complications occurred in 13 (25%) patients, with a 90-day mortality of 5.8%. The median LOS was 3 days. CONCLUSIONS: A laparoscopic hepatectomy is safe in the setting of cirrhosis, provided the application of appropriate selection criteria and sufficient experience with the procedure.
File Format	HTM / HTML
ISSN	1365182X
e-ISSN	14772574
DOI	10.1111/hpb.12098
Journal	HPB
Issue Number	2
Volume Number	16
Language	English
Publisher	Elsevier
Publisher Date	2014-02-01
Publisher Place	Great Britain (UK)
Access Restriction	Open
Subject Keyword	Discipline Gastroenterology Hepatectomy Laparoscopy Liver Cirrhosis Surgery Mortality Pathology Retrospective Studies Severity Of Illness Index Comparative Study
Content Type	Text
Resource Type	Article
Subject	Hepatology Gastroenterology

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