Laparoscopic parenchyma-sparing liver resection for colorectal metastases

  • Davit L. Aghayan
  • Egidijus Pelanis
  • Åsmund A. Fretland
  • Airazat M. Kazaryan
  • Mushegh A. Sahakyan
  • Bård I. Røsok
  • Leonid Barkhatov
  • Bjørn Atle Bjørnbeth
  • Ole Jakob Elle
  • Bjørn Edwin


Background:  Laparoscopic liver resection (LLR) of colorectal liver metastases (CLM) is performed in specialized centers. While there is a trend toward a parenchyma-sparing strategy in multimodal treatment for CLM, its role is yet unclear. In this study the short- and long-term outcomes of laparoscopic parenchyma-sparing liver resection (LPSLR) at a single center are presented.

Methods: LLR were performed in 951 procedures between August 1998 and March 2017 at Oslo University Hospital – Rikshospitalet. Patients who primarily underwent LPSLR for CLM were included in the study. LPSLR was defined as non-anatomic LLR, i.e. the patients, who underwent hemihepatectomy and sectionectomy were excluded. Perioperative and oncologic outcomes were analyzed. The Accordian classification was used to classify postoperative complications. The median follow-up was 40 months.

Results: 296 patients underwent primary LPSLR for CLM. A single specimen was resected in 204 cases, several concomitant resections were performed in 92 cases. 5 laparoscopic operations were converted to open. The median operative time was 134 minutes, blood loss was 200ml and hospital stay was 3 days. There was no 90-day mortality in this study. The postoperative complication rate was 14.5%. 189 patients developed disease recurrence. Recurrence in the liver occurred in 146 patients (49%), of whom 85 patients underwent repeated surgical treatment (liver resection [n=69], ablation [n=14] and liver transplantation [n=2]). Five-year overall survival was 48%, median overall survival was 56 months.

Conclusion: In experienced hands, LPSLR of CLM can be performed safely. The technique facilitates repeated surgical treatment, which may improve survival for patients with CLM.

Keywords: Laparoscopic parenchyma-sparing liver resection, colorectal cancer, liver metastases, survival.

How to Cite
Aghayan, D. L., Pelanis, E., Fretland, Åsmund A., Kazaryan, A. M., Sahakyan, M. A., Røsok, B. I., Barkhatov, L., Bjørnbeth, B. A., Elle, O. J., & Edwin, B. (2018). Laparoscopic parenchyma-sparing liver resection for colorectal metastases. Radiology and Oncology, 52(1). Retrieved from
Clinical oncology