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전복강경간좌외측구역절제술이 표준 술식으로 정착되기까지의 경험
이동식(Dong Shik Lee),최미란(Mei Lan Cui),김홍진(Hong Jin Kim),윤성수(Sung Su Yun) 한국간담췌외과학회 2010 한국간담췌외과학회지 Vol.14 No.3
Purpose: The aim of this study was to present our experience before establishing laparoscopic left lateral sectionectomy (LLLS) of the liver as a standard procedure, and to show efficacy of a totally LLLS compared to an open left lateral sectionectomy (OLLS). Methods: We retrospectively analyzed and compared clinical outcomes (operation time, blood loss, hospital stay, complication rate, etc) for 29 patients who underwent LLLS and 27 patients who underwent OLLS between January, 2002 and December, 2009. To see the learning curve for LLLS, we arbitrarily divided the LLLSs we did into an early group (ELLLS) and a late group (LLLLS) based on when they were operated on relative to case number 14. Results: Mean operative times for the ELLLS, LLLLS and OLLS groups were 269.7±102.6, 210.0±47.9 and 289.1±72.8 minutes, respectively. Mean operative time was significantly shorter (p<0.05) in the LLLLS than the OLLS group. Mean intra-operative blood loss was also less in the LLLLS group than the OLLS group (80.00±224.2 ml vs. 195.15±405.4 ml). Post-operative hospital stay was shorter in the LLLLS group than the OLLS group (9.9±4.0 versus 16.9±9.1, p=0.071). Conclusion: The totally LLLS is a safe, feasible treatment option that can be a standard procedure with better outcomes in selected patients after an initial learning curve.