Author/Authors :
cai, xiujun zhejiang university - sir run run shaw hospital, school of medicine, institute of minimally invasive surgery - department of general surgery, Hangzhou, China , liang, xiao zhejiang university - sir run run shaw hospital, school of medicine, institute of minimally invasive surgery - department of general surgery, Hangzhou, China , yu, tunan zhejiang university - sir run run shaw hospital, school of medicine, institute of minimally invasive surgery - department of general surgery, Hangzhou, China , liang, yuelong zhejiang university - sir run run shaw hospital, school of medicine, institute of minimally invasive surgery - department of general surgery, Hangzhou, China , jing, renan zhejiang university - sir run run shaw hospital, school of medicine, institute of minimally invasive surgery - department of general surgery, Hangzhou, China , jiang, wenbing zhejiang university - sir run run shaw hospital, school of medicine, institute of minimally invasive surgery - department of general surgery, Hangzhou, China , li, jianbo zhejiang university - sir run run shaw hospital, school of medicine, institute of minimally invasive surgery - department of general surgery, Hangzhou, China , ying, hanning zhejiang university - sir run run shaw hospital, school of medicine, institute of minimally invasive surgery - department of general surgery, Hangzhou, China
Abstract :
Background: Laparoscopic hepatectomy (LH) is highly difficult in the background of liver cirrhosis. Inthis case series, we aimed to summarize our prior experience of LH in liver cirrhosis grading Child-Pughclass B.Methods: In the LH database of Sir Run Run Shaw Hospital in Zhejiang, China, patients who werepathologically diagnosed with cirrhosis and graded as Child-Pugh class B or C were reviewed.Results: Five patients grading Child B were included. There was no Child C case in our LH database.For included cases, median blood loss (BL) was 800 (range, 240-1,000) mL, median operative time was 135(range, 80-170) minutes, and median length of hospital stay was 9 (range, 7-15) days. Forty percent (2/5)of patients was converted to open. The postoperative complication (PC) rate was 20.0% (1/5). When theseChild B cases were compared with Child A cases undergoing LH, there was no statistical significance in BL,complication rate, operative time, open rate and hospital stay (HS) (P 0.05). This finding was confirmed bytwo ways of matched comparisons (a 1:2 comparison based on age and gender, and a 1:1 propensity scorematching).Conclusions: Although relevant literatures had suggested feasibility of LH in cirrhotic cases grading ChildA, this study was the first one to discuss the value of LH in Child B cases. Our prior experience showed thatin selected patients, LH in Child B patients had the potential to be as safe as in Child A cases. The efficacy ofLH in Child C patients needs further exploration.
