Experience of laparoscopic caudate lobe resection

Objective To evaluate the safety, clinical efficacy and advantages of laparoscopic caudate lobe resection. Methods Clinical data of 17 patients undergoing laparoscopic single caudate lobe resection in West China Hospital of Sichuan University from June 2016 to June 2018 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 11 patients were male and 6 female, aged 24-73 years with a median age of 50 years. According to different surgical procedures, all patients were divided into the laparoscopic caudate lobe resection group (laparoscopic group, n=10) and open caudate lobe resection group (open group, n=7). The perioperative parameters were statistically compared between two groups by t test or rank-sum test. Results All patients in both groups completed the operation successfully. No inferior vena cava occlusion was performed. No uncontrollable massive hemorrhage occurred intraoperatively. In the laparoscopic group, the average operation time was (2.7±0.9) h and hepatic portal occlusion time was (25±10) min,significantly shorter than (3.6±0.5) h and (37±12) min in the open group (t=-2.382, -2.365; P<0.05). In the laparoscopic group, the median intraoperative blood loss was 75(40-300) ml, significantly less compared with 200(200-500) ml in the open group (Z=-3.035, P<0.05). After operation, only 1 case in the open group developed ascites. This patient recovered and was discharged after receiving albumin and diuretic. In the laparoscopic group, the ALB at postoperative 1 d was (35±2) g/L, significantly higher than (32±2) g/L in the open group (t=3.109, P<0.05). In the laparoscopic group, the postoperative length of hospital stay was 2(1-4) d, significantly shorter than 4(4-6) d in the open group (Z=-3.137, P<0.05). Conclusions Laparoscopic caudate lobe resection is a safe and effective surgical approach for patients with suitable indications. It has advantages of short operation time, slight intraoperative blood loss and rapid postoperative recovery. Key words: Hepatectomy; Laparoscopes; Caudate lobectomy