Abscess

Research from E. Wang and co-authors yields new data on hepatectomy

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"In Singapore, many centres have recently embarked on this approach. We believe that careful patient selection can facilitate scaling the learning curve. The aim of this study was to review our centre's initial outcome with laparoscopic anatomical liver resection when stringent selection criteria were applied. For our initial experience, we based our patient selection on criteria recommended by centres more experienced with laparoscopic hepatectomy. We selected only patients with small lesions confined to Couinaud's liver segments of II, III, IVB, V and VI. The surgical technique was similar in all cases, including intraoperative ultrasonography for localisation, ultrasonic shears and surgical staplers for parenchymal transection, and delivery of the specimen via a Pfannenstiel incision. No hand ports were used. Patients' records were retrospectively reviewed. Between July 2006 and August 2007, we had five consecutive patients. Their median age was 50 (range 36-66) years. Four of these patients had hepatocellular carcinomas and one had a liver abscess. The median operation time was 275 (range 250-290) minutes, and median intraoperative blood loss was 400 (range 200-700) ml. The median hospital stay was four days," wrote E. Wang and colleagues.

The researchers concluded: "At the initial stages of a laparoscopic hepatectomy programme, we propose that a stringent patient selection criteria coupled with the proper surgical expertise can ensure favourable outcomes, comparable to more established centres."

Wang and colleagues published their study in Singapore Medical Journal (Starting a laparoscopic hepatectomy programme. Singapore Medical Journal, 2009;50(4):354-359).

For additional information, contact C.K. Ho, Tan Tock Seng Hospital, Dept. of General Surgery, Center Advanced Laparoscop Surgery, Center Digestive Diseases, Hepatobiliary & Pancreat Surgery Service, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore.

Publisher contact information for the Singapore Medical Journal is: Singapore Medical Association, Level 2 Alumni Medical Centre, 2 College Rd., Singapore 169850, Singapore.

Keywords: Singapore, Singapore, Gastroenterology, Hepatectomy, Hepatology, Laparoscopy, Liver Resection, Liver Surgery, Surgery.

This article was prepared by Gastroenterology Week editors from staff and other reports. Copyright 2009, Gastroenterology Week via NewsRx.com.