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What is the Learning Curve for Laparoscopic Major Hepatectomy?
Kimberly M Brown1, David A Geller2,3
1Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA.
Summary
Laparoscopic liver resection, including major hepatectomy for cancer, is safe and effective. Oncologic outcomes are comparable to open surgery, with a learning curve of 45-60 cases for surgeons.
Area of Science:
- Minimally Invasive Surgery
- Hepatobiliary Surgery
- Surgical Oncology
Background:
- Laparoscopic liver resection is increasingly performed worldwide.
- Initially for benign lesions, it's now predominantly used for malignant tumors like hepatocellular carcinoma (HCC) and colorectal cancer liver metastases (mCRC).
Purpose of the Study:
- To review the literature on outcomes of major laparoscopic liver resection (≥3 Couinaud segments).
- To assess the safety and efficacy of this procedure for liver tumors.
Main Methods:
- Literature review of published studies.
- Evaluation of outcomes for major laparoscopic liver resections.
Main Results:
- Laparoscopic liver resection shows comparable 5-year survival rates to open surgery for HCC and mCRC.
- Concerns regarding adverse oncologic outcomes or tumor seeding have not been substantiated.
- Laparoscopic major hepatectomy is feasible with increasing experience.
Conclusions:
- Laparoscopic major hepatectomy is a safe and effective treatment for liver tumors in specialized centers.
- A learning curve of 45-60 cases is associated with laparoscopic hepatic resection.
