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HPB Surgery (2)
Annals of The Royal College of Surgeons of England (1)
JSLS : Journal of the Society of Laparoendoscopic Surgeons (1)
Lloyd, David M. (3)
Al-Leswas, Dhya (1)
Al-Taan, Omer (1)
Au-Yong, Iain T. H. (1)
Beable, Richard (1)
Dennison, Ashley R. (1)
Dyer, Martin (1)
Elsey, Elisabeth J. (1)
Lloyd, David M (1)
Mann, Christopher D (1)
Metcalfe, Matthew S (1)
Metcalfe, Matthew S. (1)
Norwood, Michael (1)
Pattenden, Clare J (1)
Robertson, Gavin S. (1)
Spencer, Laura (1)
Stephenson, James A. (1)
Strickland, Andrew D. (1)
Wemyss-Holden, Simon (1)
Year of Publication
Lessons from Laparoscopic Liver Surgery: A Nine-Year Case Series
Metcalfe, Matthew S.
Strickland, Andrew D.
Elsey, Elisabeth J.
Robertson, Gavin S.
Objective. This series describes a developing experience in laparoscopic liver surgery presenting results from 40 procedures including right hemihepatectomy, left lateral lobectomy, and microwave ablation therapy. Methods. Forty patients undergoing laparoscopic liver surgery between September 1997 and November 2006 were included. The data set includes: operative procedure and duration, intraoperative blood loss, conversion to open operation rates, length of hospital stay, complications, mortality, histology of lesions/resection margins, and disease recurrence. Results. Mean age of patient: 59 years, 17/40 male, 23/40 female, 23/40 of lesions were benign, and 17/40 malignant. Operations included: laparoscopic anatomical resections n = 15, nonanatomical resections n = 11, microwave ablations n = 8 and deroofing of cysts n = 7. Median anaesthetic time: 120 minutes (range 40–240), mean blood loss 78 mL and 1/40 conversions to open. Median resection margins were 10 mm (range 1–14) and median length of stay 3 days (range 1–10). Operative and 30-day mortality were zero with no local disease recurrence. Conclusion. Laparoscopic liver surgery appears safe and effective and is associated with reduced hospital stay. Larger studies are required to confirm it is oncologically sound.
Laparoscopic splenectomy: a personal series of 140 consecutive cases
Pattenden, Clare J
Mann, Christopher D
Metcalfe, Matthew S
Annals of The Royal College of Surgeons of England
Laparoscopic splenectomy has emerged as a safe and effective treatment for a variety of haematological conditions. The objective was to review the results from a large personal series from the perspective of outcomes according to operative time, conversion to open operation, complications and mortality. The application of laparoscopic splenectomy to cases of splenomegaly without hand assistance is examined.
Patients and Methods
A retrospective review of 140 patients undergoing laparoscopic splenectomy at a single university hospital by one surgeon during 1994-2006. Case notes were reviewed and data collected on operative time, conversion to open procedure, morbidity and mortality. Particular reference was made towards the results of cases of splenomegaly.
In total 140 laparoscopic splenectomies were performed with a complication rate of 15% and no mortality. The median operative time was 100 min and conversion to open procedure was necessary in 2.1%. Conversion for cases of splenomegaly was only 5.7%. The median hospital stay was 3 days.
Laparoscopic splenectomy is a safe procedure with acceptable morbidity. A laparoscopic approach for splenomegaly is feasible.
Laparoscopic splenectomy; Splenomegaly; Idiopathic thrombocytopenic purpura; Complications
Hepatic Haemangioma Masquerading as the Gallbladder in a Case of Gallbladder Agenesis: A Case Report and Literature Review
Stephenson, James A.
Dennison, Ashley R.
Gallbladder agenesis is uncommon. In contrast, liver haemangiomas are the most common type of benign liver lesions. We describe the first documented case of gallbladder agenesis where the clinical presentation was consistent with biliary colic, and radiological investigation suggested the presence of gallstones. Subsequent operative findings revealed a solitary haemangioma of the liver sited in the normal position of the gallbladder fossa but with absence of the gallbladder. It is important that clinicians should keep gallbladder agenesis in mind when the gallbladder appears abnormal on preoperative imaging studies and cannot be found at laparoscopy. As symptoms will improve in 98% of cases, it is very important to avoid unnecessary intervention in patients who have a negative laparoscopy. The clinical presentation, investigations, and operative findings are discussed with a review of other relevant reported cases in the literature.
Laparoscopic Distal Pancreatectomy for Lymphoepithelial Cyst of the Pancreas
Au-Yong, Iain T. H.
JSLS : Journal of the Society of Laparoendoscopic Surgeons
Lymphoepithelial cysts are rare pancreatic lesions. This case report describes the first excision of such a lesion by laparoscopic distal pancreatectomy which is a recognized procedure for treatment of cystic pancreatic neoplasms. Our patient underwent complete excision of the lesion and has enjoyed complete resolution of his symptoms. Laparoscopic distal pancreatectomy may be a suitable choice for first-line therapy for such lesions.
Laparoscopy; Distal pancreatectomy; Lymphoepithelial cyst
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