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Utility of the Iwate Difficulty Scoring System for the Stratification of Laparoscopic Right Hepatectomies: An International Multicenter Study.

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Laparoscopic liver resection: Experience based guidelines.

Fabricio Ferreira Coelho1, Jaime Arthur Pirola Kruger1, Gilton Marques Fonseca1

  • 1Fabricio Ferreira Coelho, Jaime Arthur Pirola Kruger, Gilton Marques Fonseca, Raphael Leonardo Cunha Araújo, Vagner Birk Jeismann, Ivan Cecconello, Paulo Herman, Liver Surgery Unit, Department of Gastroenterology, University of São Paulo Medical School, São Paulo, CEP 05403-900, Brazil.

World Journal of Gastrointestinal Surgery
|February 5, 2016
PubMed
Summary
This summary is machine-generated.

Laparoscopic liver resection (LLR) is a safe and feasible minimally invasive approach for liver tumors, offering short-term benefits over open surgery. Oncological outcomes are comparable, with ongoing advancements expected to expand its application.

Keywords:
Hand-assisted laparoscopyHepatectomyLaparoscopic surgeryLiverLiver cirrhosisLiver neoplasmLiver transplantationLiving donorMinimally invasive surgery

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Area of Science:

  • Hepatobiliary Surgery
  • Minimally Invasive Surgery
  • Surgical Oncology

Background:

  • Laparoscopic liver resection (LLR) has evolved significantly over 20 years.
  • Initial skepticism has given way to increased adoption due to improved outcomes.
  • Evidence from case series, comparative studies, and meta-analyses supports LLR.

Purpose of the Study:

  • To evaluate the safety, feasibility, and benefits of LLR compared to open resection.
  • To review current indications and technical considerations for LLR.
  • To assess oncological outcomes and future directions in laparoscopic liver surgery.

Main Methods:

  • Review of existing literature, including case series, comparative studies, and meta-analyses.
  • Analysis of operative results, oncological outcomes, and indications for LLR.
  • Discussion of technical challenges and the role of hand-assisted and laparoscopy-assisted techniques.

Main Results:

  • LLR is safe and feasible, with benefits over open resection.
  • Indications for LLR mirror those for open surgery, including benign and malignant tumors.
  • Oncological results (margins, survival) are non-inferior to open resection.
  • Resections of posterosuperior segments and major resections are feasible but technically demanding.

Conclusions:

  • LLR is a safe and effective alternative to open liver resection.
  • Short-term advantages and comparable oncological outcomes support LLR.
  • Further high-quality studies and technological advancements are needed to broaden LLR application.