LAUSR

M. Baltatzis, P. Stathakis, A. Mirza, A. Tyurkylmaz, S. Jamdar, A. Siriwardena and A. Sheen Department of Hepatobiliary and Pancreatic Surgery, Manchester University Hospitals, NHS Foundation Trust, United Kingdom Aim: Since the first reports of laparoscopic hepatectomy in the early 1990s there has been a gradual increase in the use of the technique. Consensus conferences in Louisville USA and Morioka Japan have provided guidance on case selection. This study reports the adoption of the laparoscopic approach by predominantly one attending (consultant) surgeon in this regional liver surgery service. Methods: Laparoscopic liver surgery was initially adopted by the lead surgeon in 2009. All operations were undertaken using a two-surgeon approach until individuals had achieved competence. Demographic data are presented as median (range) where appropriate and non-parametric tests are used for comparison accepting significance at the P < 0.05 level. Patients were allocated to one of two temporal cohorts. Results: The total number of patients in this cohort were 400 (2006-2017) (197 [49%] male; median [range] age 68 [30-88]). In the initial cohort from 2006 to 2011 the total number of liver resections undertaken were 173 with 10 (5.8%) undertaken laparoscopically. From 2012 to 2017 there were 227 liver resections with 67 (29.5%) undertaken laparoscopically. The difference in the proportion of laparoscopic cases was significant (P< 0.001). In the overall series of 400 there were 4 (1%) post-operative deaths. There were no deaths after laparoscopic liver surgery and no conversions. Conclusion: Laparoscopic hepatectomy can be safely and uneventfully incorporated into modern liver surgical practice.