Laparoscopic left lateral sectionectomy in patients with histologically confirmed cirrhosis

- Laparoscopic left lateral sectionectomy can be safely performed even in cirrhosis.
- Compared to open LLS, laparoscopic LLS showed similar outcomes.
- Laparoscopic LLS can be a routine approach to treat hepatocellular carcinoma.

BackgroundLaparoscopic left lateral sectionectomy (LLS) is now considered as a standard practice. However, the safety of laparoscopic LLS in cirrhotic patients is unclear. This is the retrospective study of comparing the outcomes of laparoscopic LLS between cirrhotic and non-cirrhotic patients.MethodsWe reviewed the clinical data for 107 patients who underwent laparoscopic LLS between July 2003 and July 2013. The patients were divided into cirrhotic group (n = 31) and non-cirrhotic group (n = 76) with histologically confirmed F4 or F3 fibrosis.ResultsThere were no differences between the two groups in terms of the operation time (P = 0.807), blood loss (P = 0.115), transfusion rate (P = 0.716), postoperative complication rate (P = 0.601) and duration of hospital stay (P = 0.261). Open conversion occurred in one non-cirrhotic patient (P = 1.000). The postoperative peak total bilirubin level was higher in cirrhotic patients than in non-cirrhotic patients (P < 0.001). Among patients with hepatocellular carcinoma, the disease-free survival (P = 0.249) and overall survival (P = 0.768) rates were not significantly different between cirrhotic patients (n = 28) and non-cirrhotic patients (n = 12). There were no significant differences in the complication rate (P = 0.085), operation time (P = 0.159), blood loss (P = 0.306), transfusion rate (P = 1.00), and hospital day (P = 0.408) between laparoscopic LLS and cases of open LLS performed in the same study period (n = 10).ConclusionsLaparoscopic LLS is safe and reproducible, even in cirrhotic patients.