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Laparoscopic major liver resections: Current standards.

Alfred Kow Wei Chieh1, Albert Chan2, Fernando Rotellar3

  • 1Division of Hepatobiliary and Pancreatic Surgery and Liver Transplantation, Department of Surgery, National University of Singapore, Singapore.

International Journal of Surgery (London, England)
|July 12, 2020
PubMed
Summary
This summary is machine-generated.

Laparoscopic liver resection has evolved significantly, overcoming initial fears to offer improved short-term patient outcomes. This minimally invasive approach provides comparable long-term oncological safety for major liver resections.

Keywords:
Laparoscopic major hepatectomyMinimally invasive liver resection

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Area of Science:

  • Hepatobiliary Surgery
  • Minimally Invasive Surgery
  • Surgical Oncology

Background:

  • Laparoscopic liver resection adoption was initially hindered by concerns regarding safety and technical limitations.
  • Early challenges included fear of gas embolism, bleeding risks, and inadequate instrumentation for major resections.

Purpose of the Study:

  • To trace the evolution of laparoscopic major hepatectomy.
  • To review technical advancements and lessons learned in laparoscopic liver resection.
  • To assess current outcome standards for laparoscopic major hepatectomy.

Main Methods:

  • Literature review of over 9000 reported cases of laparoscopic liver resection.
  • Analysis of short-term outcomes (morbidity, blood loss, pain, recovery).
  • Evaluation of long-term oncological outcomes (R0 resection, survival rates).

Main Results:

  • Laparoscopic major liver resection demonstrates reduced operative morbidities, blood loss, pain, and shorter hospital stays.
  • Oncological outcomes, including R0 resection rates and survival, are comparable to open procedures.
  • Numerous innovations have enhanced the feasibility of complex laparoscopic hepatectomies.

Conclusions:

  • Laparoscopic major hepatectomy has matured into a safe and effective procedure.
  • It offers significant short-term benefits without compromising long-term oncological results.
  • Continued advancements support its widespread application in liver surgery.