Minimally invasive hepatectomy in ambulatory surgery: a retrospective study on prospectively collected data in a consecutive patient cohort.

BACKGROUND

Ambulatory surgery effectively optimizes the allocation of medical resources and reduces patients' hospitalization time and related costs. Minimally invasive hepatectomy in ambulatory surgery (MIHAS) is rarely reported due to complexity of perioperative management and technical challenges. This study aimed to evaluate safety and feasibility of MIHAS.

METHODS

The demographics and short-term outcomes of a consecutive series of patients who underwent MIHAS between July 01, 2024, and January 01, 2025, were analyzed.

RESULTS

Thirty-four patients (26 males and eight females, mean age, 56 years). Ten patients underwent left lateral hepatectomy, 19 underwent segmentectomy, and five underwent wedge hepatectomy. All MIHAS procedures were successfully performed without conversion to open surgery. The median operative time was 105 (89.5, 121.5) min, and median estimated blood loss was 35 (20, 50) ml. No patient required a blood transfusion. No patient experienced major postoperative complications (Clavien-Dindo grade ≥ III), post-hepatectomy liver failure, postoperative bile leakage, post-hepatectomy hemorrhage. No patient required reoperation or readmission to the hospital, and no 30-day mortality was observed.

CONCLUSION

MIHAS can be safely and feasibly implemented in high-volume minimally invasive teams in selected patients. Further research and more surgical experience are needed to determine the indications for MIHAS.