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Surgical Endoscopy

, Volume 32, Issue 4, pp 2012–2019 | Cite as

Laparoscopic parenchymal sparing resections in segment 8: techniques for a demanding and infrequent procedure

  • David Martínez-Cecilia
  • Martina Fontana
  • Najaf N. Siddiqi
  • Mark Halls
  • Salvatore Barbaro
  • Mohammad Abu-Hilal
Article

Abstract

Background

Laparoscopic liver resections for lesions in the postero-superior segments are technically demanding due their deep location and relation with the vena cava. However, previous reports have demonstrated the feasibility and safety of these resections in centres with advanced experience in laparoscopic liver surgery. In this case series, we present our results and experience of laparoscopic parenchymal sparing liver resections of lesions in segment 8.

Methods

All patients undergoing laparoscopic liver resections of segment 8 lesions, alone or combined with other liver resections, between August 2003 and July 2016 were included. Analysis of baseline characteristics and perioperative results was performed for the whole cohort. A separate subgroup analysis was performed for isolated segment 8 resections. Long-term results were analyzed in patients with colorectal liver metastases. A video is attached for thorough explanation of surgical technique.

Results

A total of 30 patients were included. Among them, 13 patients had isolated segment 8 resections. Operative time for the whole cohort and isolated segment 8 resections were 210 min (range 180–247 min) and 200 min (range 90–300 min), respectively. The conversion rate was 3.4% for the entire cohort and 0 for isolated segment 8 resections. Major morbidity was 7 and 0%, respectively. R0 rates were 96% for the entire cohort and 92% for isolated segment 8 resections. Recurrence free survival in the colorectal liver metastasis subgroup was 82, 71 and 54% at 1, 3 and 5 years. Overall survival was 94, 82 and 65% at 1, 3 and 5 years.

Conclusions

Laparoscopic resection of lesions in segment 8 is feasible and offers the benefits of minimally invasive surgery with parenchyma sparing resections. However, advanced experience in LLR is essential to ensure safety and oncological results.

Keywords

Laparoscopy Liver Segment 8 Postero-superior segments Parenchymal sparing resection 

Notes

Compliance with ethical standards

Disclosures

David Martínez-Cecilia, Martina Fontana, Najaf N. Siddiqi, Mark Halls, Salvatore Barbaro, Mohammad Abu Hilal have no conflicts of interest or financial ties to disclose.

Supplementary material

Supplementary material 1 (MP4 152703 KB)

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • David Martínez-Cecilia
    • 1
    • 2
  • Martina Fontana
    • 1
  • Najaf N. Siddiqi
    • 1
  • Mark Halls
    • 1
  • Salvatore Barbaro
    • 1
  • Mohammad Abu-Hilal
    • 1
  1. 1.Department of Hepato-Biliary and Pancreatic SurgeryUniversity Hospital Southampton, NHS Foundation TrustSouthamptonUK
  2. 2.Hospital Universitario de ToledoToledoSpain

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