A standardized laparoscopic left lateral sectionectomy in liver resection

Objective A retrospective analysis was conducted on standardized laparoscopic left lateral sectionectomy in liver resection (LLLR) using the Step Two Endo-GIA procedure. The aim of the study was to improve safety and efficacy of the operation. Methods All patients who underwent LLLR in Department of General Surgery, the First Affiliated Hospital of Soochow University from May 2014 to July 2018 were included in the study. All patients were divided into laparoscopic group (n=56) and open group (n=44). The operative plan followed the standardized procedure used in our department. Results Of 56 patients, there were 28 males and 28 females. No hepatic hilar occlusion was required and no case was converted to laparotomy. The average age was (55.7±13.0), tumor diameter (6.3±3.7) cm, liver dissection time (30.0±10.9) min, intraoperative blood loss (142.3±22.8) ml, and postoperative length of hospital stay (6.1±2.4) d. The average follow-up was (36.6±10.1) months. One patient developed mild bile leakage and recovered after drainage. The other patients had no serious postoperative complications. The laparoscopic group was superior to the open group in operation time (90.0±17.0 vs. 129.3±38.8) min, fasting time (1.5±1.0 vs. 2.1±1.1) d, TBil (13.0±2.6 vs. 19.0±3.1) μmol/L and ALT (80.0±19.3 vs. 200.0±32.1) U/L. Conclusion A standardized LLLR has the advantages of short operation time, good reproducibility and short learning curve. It can be used as a standard procedure at all hospital levels. Key words: Laparoscopes; Surgical procedures, minimally invasive; Left lateral segment liver resection; Standardization