Chirurgia del Fegato a Firenze!

Dal 1° Marzo 2023, Chirurgia del Fegato sarà all'Università di Firenze
AOUC Azienda Ospedaliero-Universitaria Careggi - Largo Brambilla, 3 - 50134 Firenze

Prima serie di resezioni epatiche maggiori eseguite per via laparoscopica

Cristiano Hüscher  pubblica la prima serie di resezioni epatiche maggiori condotte per via laparoscopica ed eseguite al Reparto di Chirurgia Generale dell’Ospedale Vallecamonica a Esine, Italia.

L’intera serie comprendeva 20 resezioni epatiche laparoscopiche: 6 epatectomie sinistre, 5 epatectomie destre di cui una estesa al quarto segmento, 3 mesoepatectomie, 5 segmentectomie ed una bisegmentectomia.

La referenza bibliografica per questo evento è:

CG Hüscher, MM Lirici, S Chiodini, A Recher: Current position of advanced laparoscopic surgery of the liver.. In: J R Coll Surg Edinb. 1997 Aug;42(4):219-25. PMID: 9276552., vol. 42, iss. 4, pp. 219-25, 1997.

Abstract

With the improvement of laparoscopic techniques and the development of new and dedicated technologies, endoscopic liver surgery has become feasible. While wedge liver resections are performed more and more frequently, laparoscopic anatomical liver resections are still at an early stage of development and are somewhat controversial. In 1993 we initiated formal laparoscopic liver resections in selected patients. From 1993 to December 1995 20 patients underwent endoscopic formal resections: the procedures comprised six left hepatectomies, five right hepatectomies, one of which extended to the segment IV, three mesohepatectomy, five segmentectomies and one bisegmentectomy. The operation time ranged from 120 to 270 min (average 193 min). In 17 out of 20 cases a Pringle manoeuvre was performed (mean occlusion time 45 min). No intra-operative complications occurred and there were no conversions in the whole series. Average intra-operative blood loss was 397.5 mL and 35% of patients required intro-operative blood transfusions. Post-operative mortality rate was 5% and post-operative morbidity rate was 45% (one coagulopathy with severe trombocytopaenia, six pleural effusions, one bile collection and four hematomas of the trocar sites). Such preliminary data are comparable with those of a group of 65 patients who underwent open anatomical liver resections from 1992 and 1995. Far from being a routine technique in liver surgery, the laparoscopic approach to forma liver resections may be a promising procedure in selected patients.

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Chirurgia del Fegato all'Università di Firenze!

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AOUC Azienda Ospedaliero-Universitaria Careggi
Largo Brambilla, 3 – 50134 Firenze

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