Laparoscopic Surgery for Liver and Pancreatic Neoplasms
Aim. To analyze early outcomes of laparoscopic surgery and to show their advisability in surgical treatment of liver and pancreatic neoplasms. Material and Methods. There were 60 patients with liver tumors and 44 patients with pancreatic neoplasms who underwent laparoscopic surgery. Prospective control groups consisted of patients after conventional procedures. Results. Overall incidence of postoperative complications was 8.3% after laparoscopic liver interventions that was significantly less than in open procedures. Incidence of post-resection liver failure and biliary complications (ISGLS, 2011) was similar after laparoscopic and open liver interventions. Overall complication rate after laparoscopic pancreatic surgery was 6.8% that was significantly lower compared with standard interventions. Incidence of postoperative fistula (ISGPF, 2005) was 4.5% (Grade A - 2.3%, Grade B - 2.3%), that was significantly less than in open surgery 29.5% (Grade A - 15.9%, Grade B - 16.5%). The length of hospital-stay after laparoscopic interventions was less than after open procedures in both groups of patients. There was no in-hospital mortality. Conclusion. Laparoscopic surgery for liver and pancreatic neoplasms is associated with significantly reduced overall morbidity and postoperative hospital-stay, accelerated rehabilitation. Laparoscopic pancreatectomy decreases incidence of postoperative pancreatic fistulae Grade A and, especially, Grade B.