Glissonean approach for hepatic inflow control in minimally invasive anatomic liver resection: A systematic review

Abstract

Background:The Glissonean approach has been widely validated for both open and minimally invasive anatomic liver resection (MIALR). However, the possible advantages compared to the conventional hilar approach are still under debate. The aim of this systematic review was to evaluate the application of the Glissonean approach in MIALR. Methods: A systematic review of the literature was conducted on PubMed and Ichushi databases. Articles written in English or Japanese were included. From 2,390 English manuscripts evaluated by title and abstract, 43 were included. Additionally, 23 out of 463 Japanese manuscripts were selected. Duplicates were removed, including the most recent manuscript. Results: The Glissonean approach is reported for both major and minor MIALR. The 1st, 2nd and 3rd order divisions of both right and left portal pedicles can be reached How to cite this article: Morimoto M, Tomassini F, Berardi G, et al. Glissonean approach for hepatic inflow control in minimally invasive anatomic liver resection: A systematic review.

Minimally invasive anatomic liver resection: Results of a survey of world experts

“…However, this is still under discussion. Therefore, we firstly performed systematic reviews to obtain existing evidence 2‐4 . Next, we sought opinions from the selected experts throughout the world and explored a reasonable method for safely carrying out MIALR.…”

“…Anatomic liver resection (ALR) is defined as complete removal of the liver parenchyma confined within the responsible portal territory without leaving any ischemic or congested area. Despite the existence of systematic reviews of inflow/outflow control, and segmental borders in MIALR, before the Expert Consensus Meeting, “Precision Anatomy for Minimally Invasive Hepato‐Biliary‐Pancreatic Surgery” (PAM‐HBP Surgery), held in Tokyo in February 2021, there was no clear consensus on the safe implementation of MIALR 2‐4 . To discuss and establish clear standards for performing MIALR, we asked 28 questionnaires to selected experts from around the world who were attending PAM‐HBP Surgery to find out how they approach and perform MIALR.…”

Expert Consensus Guidelines: How to safely perform minimally invasive anatomic liver resection

“…These summaries and all the tables were provided to the experts committee to help in formulating their recommendations for each CQ. The detailed results and the process of this literature review have been previously published elsewhere 2‐4 …”

“…The main limitation of this manuscript is that the recommendations are not based on high-level evidence. Although we have already reported systematic reviews, [2][3][4] there were no prospective randomized controlled trials in the literature reviews. Instead, most of the literature was categorized as "expert opinions" and "case series", which were evaluated as low-level evidence.…”

“…The detailed results and the process of this literature review have been previously published elsewhere. [2][3][4] An expert survey was simultaneously performed to collect experts' opinions. The survey group consisted of experts from Spain, France, Italy, and Japan, who identified survey questions regarding MIALR anatomy and approach topics which were then approved by the steering committee.…”