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Gastroenterology Research and Practice
Volume 2017, Article ID 6868745, 7 pages
https://doi.org/10.1155/2017/6868745
Research Article

Laparoscopic Hepatectomy: Current State in Japan Based on the 4th Nationwide Questionnaire

1Department of Surgery, Institute of Gastroenterology, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan
2Department of Surgery, Ageo Central General Hospital, 1-10-10 Kashiwaza, Ageo-shi, Saitama, Japan
3Division of General and Gastroenterological Surgery, Department of Surgery (Omori), Toho University School of Medicine, 6-11-1 Ohmori-nishi, Ohta-ku, Tokyo, Japan

Correspondence should be addressed to Yutaka Takahashi; pj.ca.umwt.egi@akatuy

Received 13 September 2016; Revised 7 January 2017; Accepted 23 January 2017; Published 12 March 2017

Academic Editor: martin hubner

Copyright © 2017 Yutaka Takahashi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. Since laparoscopic hepatectomy (LH) became covered by national health insurance in April 2010 in Japan, the numbers of applied cases and institutions performing it have increased and the indication has expanded. We surveyed the current state and safety of LH in Japan. Methods. A questionnaire survey was performed in 41 institutions related to the Japanese Endoscopic Liver Surgery Study Group and 747 institutions certified by the Japanese Society of Gastroenterological Surgery, and responses concerning all 2962 cases of LH performed by August 2011 were obtained. Results. The surgical procedure employed was hemihepatectomy in 234 (8%), segmentectomy in 88 (3%), left lateral segmentectomy in 434 (15%), segmentectomy in 156 (5%), and partial resection in 1504 (51%) cases. The approach was pure laparoscopy in 1835 (63%), hand-assisted laparoscopic surgery in 201 (7%), and laparoscopy-assisted surgery in 926 (31%). Regarding perioperative complications, surgery was switched to laparotomy in 59 (2.0%), reoperation was performed in 4 (0.1%), and surgery-related death occurred in 2 (0.07%). Intraoperative accidents occurred in 68 (2.3%), and postoperative complications developed in 94 (3.2%). Conclusions. When the selection of cases is appropriate, LH for liver diseases can be safely performed.