Background

Laparoscopic techniques have become the standard approach for most liver resections. Clinical studies providing conclusive evidence which patients benefit most from minimal-invasive surgery remain limited.

Methods

We retrospectively analyzed data of all consecutive cases of laparoscopic liver resection between 2015 and 2018 at our center. We compared patients with and without prior abdominal surgeries with respect to postoperative complications (Clavien-Dindo score), length of operation, length of ICU stay and length of hospitalization in univariate and multivariate analyses.

Results

Within the study period 319 patients underwent laparoscopic liver resections, 44% of which had a history of abdominal surgeries. Pre-operative characteristics were similar to patients without prior surgeries. Both groups showed comparable rates of post-operative complications (Clavien-Dindo score ≥3a; 12% in patients without vs. 16% with prior surgeries, p = 0,322). There were no significant differences in length of surgery or length of stay in the ICU or in the hospital.

Conclusion

Our data suggest that history of prior abdominal surgery is not a risk factor for post-operative complications after laparoscopic liver resection. We conclude that prior abdominal surgery should not be considered a contra-indication for laparoscopic approach in liver resection.

中文翻译：

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有腹部手术史患者腹腔镜肝切除术的安全性和可行性。

背景

腹腔镜技术已成为大多数肝切除术的标准方法。为患者从微创手术中获益最多的结论性证据的临床研究仍然有限。

方法

我们回顾性分析了我们中心 2015 年至 2018 年所有连续腹腔镜肝切除病例的数据。我们在单变量和多变量分析中比较了既往接受过腹部手术和未接受过腹部手术的患者的术后并发症（Clavien-Dindo 评分）、手术时间、ICU 住院时间和住院时间。

结果

在研究期间，319 名患者接受了腹腔镜肝切除术，其中 44% 有腹部手术史。术前特征与未接受过手术的患者相似。两组的术后并发症发生率相当（Clavien-Dindo 评分≥3a；未接受过手术的患者为 12%，之前接受过手术的患者为 16%，p = 0,322）。手术时间或ICU或住院时间没有显着差异。

结论

我们的数据表明，既往腹部手术史不是腹腔镜肝切除术后并发症的危险因素。我们得出结论，既往腹部手术不应被视为腹腔镜肝切除术的禁忌症。