OP 83. Laparoscopic Liver Resection in Patient with the Previous Abdominal Surgerypest

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Y. Okuda, E. Hatano, S. Seo, K. Taura, K. Yasuchika, A Mori, T. Kaido, S. Uemoto

Chair(s): György Wéber, Mehmet Fatih Can & Norbert Németh

9:20 - 9:30h at Pest Room (C)

Categories: Oral Session, Robotic and Minimal Invasive Surgery

Session: Oral Session IX - Robotic and Minimal Invasive Surgery

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Background
Hepatocellular carcinoma and liver metastasis from colorectal cancer often occur intrahepatic recurrence even after hepatic resection and many patients need for repeated hepatectomy. The aim of this study is to assess the safety and the feasibility of laparoscopic hepatic resection (LHR) in the patients with the previous history of abdominal surgery.

Material and Methods
Among 104 patients who underwent LHR for hepatocellular carcinoma (HCC; n=73) or metastatic liver tumor (MLT; n=31), 41 patients had the history of abdominal surgery (AS group) and the others had no history of abdominal surgery (NAS group). In AS group, 14 patients had the history of surgery in the upper abdomen, especially 9 patients underwent hepatectomy.

Result
In AS group, the numbers of the patients with HCC and MLT were15 and 26, and, in NAS group, 58 and 5, respectively (p<0.001). In AS group and in NAS group, the mean ICGR15 was 13% and 21% (p<0,001), and the ratio of Child-Pugh classification A was 100% and 87% (p=0.02). The median operative time, blood loss, the frequency of the use of Pringle maneuver, open conversion rate and the mean hospital stay had no significant difference (270min vs 264min, p=0.50; 120ml vs 150ml, p=0.10; 51% vs 52%, p=0.91; 2.4% vs 3.2%, p=1.0; 15days vs 13days, p=0.41). There was no significant difference of the morbidity in AS and NAS group (5% vs 11%, p=0.48).

Conclusion
Conclusion LHR in patients with the history of abdominal surgery was safe and feasible