• Airazat M Kazaryan, Irina Pavlik Marangos, Arne R Rosseland, Bård I Røsok, Tom Mala, Olaug Villanger, Oystein Mathisen, Karl-Erik Giercksky, and Bjørn Edwin.
• Interventional Centre, Rikshospitalet University Hospital, Oslo, Norway. kazaryan@gmail.com
• Arch Surg. 2010 Jan 1;145(1):34-40.

BackgroundThe introduction of laparoscopic liver resection has been challenging because new and safe surgical techniques have had to be developed, and skepticism remains about the use of laparoscopy for malignant neoplasms. We present herein a large-volume single-center experience with laparoscopic liver resection.DesignRetrospective study.SettingRikshospitalet University Hospital.PatientsOne hundred thirty-nine patients who underwent 177 laparoscopic liver resections in 149 procedures from August 18, 1998, through October 14, 2008. One hundred thirteen patients had malignant lesions, of whom 96 had colorectal metastases.InterventionLaparoscopic liver resection for malignant and benign lesions.Main Outcome MeasuresPerioperative and oncologic outcomes and survival.ResultsFive procedures (3.4%) were converted to laparotomy and 1 (0.7%) to laparoscopic radiofrequency ablation. The remaining 143 procedures were completed laparoscopically, during which 177 liver resections were undertaken, including 131 nonanatomic and 46 anatomic resections. The median operative time and blood loss were 164 (50-488) minutes and 350 (<50-4000) mL, respectively. There were 10 intraoperative (6.7%) and 18 postoperative (12.6%) complications. One patient (0.7%) died. The median postoperative stay and opioid requirement were 3 (1-42) and 1 (0-11) days, respectively. Tumor-free resection margins determined by histopathologic evaluation were achieved in 140 of 149 malignant specimens (94.0%). The 5-year actuarial survival for patients undergoing procedures for colorectal metastases was 46%.ConclusionsIn experienced hands, laparoscopic liver resection is a favorable alternative to open resection. Perioperative morbidity and mortality and long-term survival after laparoscopic resection of colorectal metastases appear to be comparable to those after open resections.

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