Total laparoscopic right hemihepatectomy through anterior approach for larger tumors in the right lobe of the liver

Objective To explore the feasibility and safety of laparoscopic right hemihepatectomy (LRH) via anterior approach for larger tumors in the right lobe of the liver. Methods A retrospective study was conducted based on the clinical data of ten consecutive patients with large right liver cancer undergoing LRH through anterior approach and thirty-seven patients undergoing open hemihepatectomy by anterior approach in recent 6 years. Results Between the two groups there were no significant difference in gender, average age, the mean tumor size, preoperative liver reserve function, cut margin and intraoperative blood transfusion. The LRH group had less average intraoperative blood loss [(408±158)ml vs.(520±153)ml, t=2.047, P=0.046] and shorter postoperative hospital stay [(11.5±2.8)d vs.(16.2±4.6)d, t=3.091, P=0.003], longer operation time [(302±38)min vs.(251±55)min, t=2.732, P=0.009]. There was no perioperative death and no significant difference in complications (20.0% vs.35.1%, χ2=0.812, P=0.367) and similar median survival time (36 mon vs.29 mon, χ2=1.266, P=0.261). Conclusions LRH via anterior approach for larger tumors in the right lobe of the liver is safe and feasible. Key words: Liver neoplasms; Laparoscopes; Hepatectomy