한국간담췌외과학회지 (Annals of Hepato-Biliary-Pancreatic Surgery)

  • 제13권3호
  • /
  • Pages.137-142
  • /
  • 2009
  • /
  • 2508-5778(pISSN)
  • /
  • 2508-5859(eISSN)
한국간담췌외과학회 (The Korean Association of Hepato-Biliary-Pancreatic Surgery)
권호 표지

전 복강경적 간절제술

Total Laparoscopic Liver Resection

  • 임재혁 (건양대학교 의과대학 외과학 교실) ;
  • 최인석 (건양대학교 의과대학 외과학 교실) ;
  • 최원준 (건양대학교 의과대학 외과학 교실)
  • Lim, Jae-Hyeok (Department of Surgery, Konyang University Hospital, Konyang University College of Medicine) ;
  • Choi, In-Suk (Department of Surgery, Konyang University Hospital, Konyang University College of Medicine) ;
  • Choi, Won-Jun (Department of Surgery, Konyang University Hospital, Konyang University College of Medicine)
  • 발행 : 2009.09.30

⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: The aim of this study was to determine whether liver resection treated by using laparoscopy is equally safe for patients who have benign liver mass, hepatolithiasis, hepatocellular carcinoma (HCC), or metastatic liver cancer. Methods: We performed our study in 32 patients with the following conditions: 17 patients with IHD stones, 7 with HCC, 1 with cholangiocarcinoma, and 7 patients who had colon cancer with liver metastasis. On a retrospective bases, these patients were investigated for clinical history, type of operation, time for the operation, hospital stay, and post operative complications. Results: The target age range was from 37 to 80 years and the mean age was 61.2 years old. The percentage of patients over 60 years old was 68.7%. According to their past history, 8 patients had experienced an upper abdominal operation. In our study there were 9 cases of left hepatectomy (28.1%), 9 cases of left lateral segmentectomy (28.1%), 2 cases of sectionectomy, and 12 cases of wedgeresection. The average operation time was 364${\pm}$148 mins, the average bleeding amount was 417 CC, and the average hospital stay was 13.2 days. There were 8 cases (25%) of postoperative complications developed (2 bile leak, 1 intrabdominal abscess, 1 acute renal failure, 2 wound infection). All cases were improved with conservative management. And there was one case of remnant IHD stone, which had surgical treat and one patient had peritoneal carcinomatosis, who had laparoscopic liver resection for HCC. Conclusion: Our study showed that laparoscopic liver resection has advantages; it is less painful, causes a small operative scar, a the short period of hospital stay and has cosmetic benefits. In the future, laparoscopic liver resection could be an important option for the treatment of hepatolithiasis and HCC through improved surgical instrument and skill of operation.

키워드

참고문헌

  1. Gagner M, Rheault M, Dubuc J. Laparoscopic partial hepatectomy for liver tumor. Surg Endosc 1992;6:97-98.
  2. Gagner M, Rogula T, Selzer D. Laparoscopic liver resection: benefits and controversies. Surg clin North Am 2004;84:451-462. https://doi.org/10.1016/j.suc.2003.11.002
  3. Cherqui D, Husson E, Hammoud R, Malassagne B, Stephan F, Bensaid S, et al. Laparoscopic liver resection: a feasibility study in 30 patients. Ann Surg 2000;232:753-762. https://doi.org/10.1097/00000658-200012000-00004
  4. Descottes B, Lachachi F, Sodji M, VAlleix D, Durand-Fontanier S, Pech de Laclause B, et all. Early experience with laparoscopic approach for solid liver tumors: initial 16 cases. Ann Surg 2000;232:641-645. https://doi.org/10.1097/00000658-200011000-00004
  5. Azagra JS, Goergen M, Gilbart E. et al. Laparoscopic anatomical(hepatic) lateral segmentectomy. : technical aspects. Surg Endosc 1996;10:758-761. https://doi.org/10.1007/BF00193052
  6. Fabiani P, Katkhouda N, Iovine L, Moujel J. Laparoscopic fenenstration of biliary cysts. Surg Laprosc Endosc 1991;1:162-165.
  7. Lefor AT, Flowers JL. Laparoscopic wedge biopsy of the liver. Am Coll Surg 1994;178:307-308.
  8. O' Rouke N, Fielding G. Laparoscopic right hepatectomy: surgical technique. J Gastrointest Surg 2004;8:213-216. https://doi.org/10.1016/j.gassur.2003.11.008
  9. Yoon YS, Han HS, Choi YS, Jang JY, Suh KS, Kim SW, et al. Total laparoscopic right posterior sectionectomy for hepatocellular carcinoma. J Laparoendosc Adv Surg Tech A 2006;16:274-277. https://doi.org/10.1089/lap.2006.16.274
  10. Dulucq J. Wintringer P, Stabilini C, Mahajna A. Isolated laparoscopic resection og the hepatic caudate lobe: surgical thchnique and a report of 2 cases. Surg Laparosc Endosc Percutan Tech 2006;16:32-35. https://doi.org/10.1097/01.sle.0000202183.27042.63
  11. Dubois F, Berthelot G, Levard H. Laparoscopic cholecystectomy: historical perspective and personal experience Surg Endsc 1991;1:52-60.
  12. Reddick EJ, Berthelot G, Levard H. Laparoscopic laser cholecystecomy: A comparison with mini-lap cholecystectomy. Surg Endosc 1989;1:52-60.
  13. Gigot JF, Glineur D, Azagra JS, Goergen M, Ceuterick M, Morino M, et al. Laparoscopic liver resection for malignant liver tumors: preliminary results of a multicenter European study. Ann Surg 2002;236:90-97. https://doi.org/10.1097/00000658-200207000-00014
  14. Kaneko H, Laparoscopic hepatectomy: indication and outcomes. J Hepatobiliary Pancreat Surg 2005;12:438-443. https://doi.org/10.1007/s00534-005-1028-6
  15. Johnstone PA, Rohde DC, Swartz SE, Fetter JE, Wexner SD. Port site recurrences after laparoscopic and thoracoscopic procedure in malignancy. J Clin OncoI 1996;86:1397-1400.
  16. Morino M, Morra I, Rosso E, Miglietta C, Garrone C. Laparoscopic vs open hepatic resection: A comparative study. Surg Endosc 2003;17:1914-1918. https://doi.org/10.1007/s00464-003-9070-4
  17. Xiujun C, Yifan W, Hong Y, et al. Laparoscopic hepatectomy for hepatolithiasis: a feasibility and safety study in 29 patients. Surg Endosc 2007;21:1074-78. https://doi.org/10.1007/s00464-007-9306-9
  18. Choi WJ, Min SK, Lee HK, et al. Comparison of clinical and surgical outcomes between unilateral and bilateral intrahepatic duct stones disease. Korean Surg Soc 2005;11:487-91.
  19. Go SJ, Lee MK, Park SJ, et al. Surgical outcome of hepatic resection for Hepatolithiasis. Korean HBP Surg 2007;11 :28-33.
  20. Belli G, Fantini C, D'Agostino A, Belli A, Russolillo N. Laparoscopic liver resections for hepatocellular carcinoma in cirrhotic patients. HPB 2004;6:236-246. https://doi.org/10.1080/13651820410023941
  21. Rau HG, Buttler E, Meyer G, Schardey HM, Schildberg FW. Laparoscopic liver resection compared with conventional partial hepatectomy-a prospective analysis. Hepatogastroenterology 1998;45:2333-2338.
  22. Farges O, Jagot P, Kirstetter P, Marty J, Belghiti J. Prospective assessment of the safety and benefit of laparoscopic liver resections. J Hepatobiliary Pancreat Surg 2002;9:242-248. https://doi.org/10.1007/s005340200026
  23. Descottes B, Clineur D, Lachachi F, Valleix D, Paineau J, Hamy A, et al. Laparoscopic liver resection of benign liver tumors. Surg Endsc 2003;17:23-30. https://doi.org/10.1007/s00464-002-9047-8