Laparoscopic hepatectomies

Aim: To report the current indications and techniques of laparoscopic liver resections, and assess the results of this technique by reviewing international literature. Review of the literature: About 200 laparoscopic hepatectomies have been reported from 1991 to 2001. 102 resections were performed for malignant tumours, and 84 for benign turnours. Global conversion rate was 7% (13/186). Morbidity rate was 16,1%, with two cases of possible gas embolisms (1.1%). Mortality rate was 0.54% (1 /186 patients). Mean hospital stay was 7.7 days. Conclusion: Laparoscopic hepatectomy is feasible, with a morbidity and mortality rate comparable to open procedures according to a careful selection of patients. However, prospective randomized trials are still needed to confirm those results, especially for resection of metastasis or malignant tumors. Evolution of laparoscopic hepatectomies will probably depend on the development of new techniques and instrumentations. (C) 2002 Editions scientifiques et medicales Elsevier SAS.