الفهرس 
Anatomy Of The LiverOnly 14 pages are availabe for public view
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Abstract
The study involved 30 patients with hepatic tumors (benign and malignant) with predominant malignant tumor managed by hepatic resection (laparoscopic and open) at Menoufiya University Hospital and El-Salam Oncology Center during the period from Oct 2012 to Dec 2014. The patient divided into 2 groups, group A (15patients) managed with LLR and group B (15 patients) managed with OLR . The median patients age in group A were 53.20±8.92 y ranged between 30- 65 years while group B was 51.71±11.44 y ranged between 36-61 with no statistical difference. There was 10 (66.7%) males and 5 (33.3%) females in lap group, while 12 (80%) males and 3 (20%) females in open group . The indication for surgery in group A 1 (6.7%) case of benign tumor (hemangioma), and 14 (93.3%) cases of malignant tumors (HCC and colorectal metastasis) while group B there was 2 (13.3%) cases of benign tumors (hemangioma and adenoma) and 13 (86.7%) cases of malignant tumors (HCC). There was no intra operative bleeding in both groups with mean operative blood loss in group A 260.46±96.20 mL while in group B was 440.74±120.61 mL with highly significant less blood loss in lap group. The duration of surgery was significantly lower in open group with mean operative time in group A 131.54±15.61 min while group B was 118.04±20.61min . The time of 1st oral intake was 1.60±1.45 days in group A while in group B was 2.93±1.08 days with significant earlier oral intake in lap group. The duration of hospital stay was highly significant lower in lap group with the mean of 6.20±1.10 days while in open group was 8.81±1.50 days as regarding that the lap surgery the minimally invasive surgery done through small incision the duration of parentral analgesia was significantly lower in group A with mean of 2.85±0.74 days while was in group B 3.85±0.98 days . There was 1 case of post operative complication in group A in the form of bile leakage while there was 6 cases of complication in open group in the form of 1 case of cirrhotic decompensation (ascitis), 2 cases of bile leakage, 1 case of chest infection and 2 cases of wound infection with significantly less overall complication rate in group A. The mean cost in this study in group A was 12000.17±2500.09 LE ranging from 8000-16000 LE while the mean cost in group B was 7000.51±1125.12 LE ranging from 5000-9000 LE with highly significant lower cost in open group than laparoscopic group . There was no involved margin in both groups with significant safety margin in group A with mean of 18.50±2.98 mm while in group B was 13.70±1.87 mm. Also there was no cutenous metastasis in either group . During the period of early follow up from the date of operation there was no recurrence in the pathology or mortality among the 30 cases of both groups. 2 cases of open group developed an incisional hernia at the mercedes incision wound, 1 after 2 months and the other after 3 months from the date of operation.