Laparoscopic right hepatectomy:

O’Rourke, Nicholas; Fielding, George

doi:10.1016/j.gassur.2003.11.008

Cited by 216 publications

(140 citation statements)

References 14 publications

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“…However, during laparoscopic hepatoectomy, it would be impossible to use these methods, since they can lead to bleeding more easily [12] . The negative pressure of the hepatic vein and the positive pressure of the abdominal cavity cause CO2 gas embolism in the blood more easily during laparoscopic hepatoectomy [13,14] . Thus, laparoscopic hepatoectomy is considered a difficult operation with a high risk requiring high techniques [15,16] .…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic hepatic left lateral lobectomy combined with fi ber choledochoscopic exploration of the common bile duct and traditional open operation

Zhang¹,

Zhang²,

Jiang³

et al. 2008

WJG

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AIM:To investigate the possibilities and advantages of laparoscopic hepatic left lateral lobectomy combined with fiber choledochoscopic exploration of the common bile duct compared with traditional open operation. METHODS:Laparoscopic hepatic left lateral lobectomy combined with fiber choledochoscopic exploration of the common bile duct and traditional open operation were performed in two groups of patients who had gallstones in the left lobe of liver and in the common bile duct. The hospitalization time, hospitalization costs, operation time, operative complications and post-operative liver functions of the two groups of patients were studied. RESULTS:The operation time and post-operative liver functions of the two groups of patients had no significant differences, while the hospitalization time, hospitalization costs and operative complications of the laparoscopic hepatic left lateral lobectomy combined with fiber choledochoscopic exploration in the common bile duct group were significantly lower than those in the traditional open operation group. CONCLUSION:

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Section: Discussionmentioning

confidence: 99%

Laparoscopic hepatic left lateral lobectomy combined with fi ber choledochoscopic exploration of the common bile duct and traditional open operation

Zhang¹,

Zhang²,

Jiang³

et al. 2008

WJG

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“…The rate of postoperative complications reported in the literature varies among studies, with lower rates reported in series with predominantly minor resections 8,12 and higher rates reported in series with predominantly major resections. 6,7,20 Most severe complications can be managed with interventions without general anesthesia. Only 1 patient in our study required reoperation, and this was because of postoperative intra-abdominal hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

Starting a new laparoscopic liver surgery program: initial experience and improved efficiency

Liang

Jayaraman

2015

Can J Surg

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Background: Owing to the anatomic complexity of the liver and the risk of hemorrhage, most liver resections are still performed using an open procedure. We evaluated the outcomes of introducing a laparoscopic liver program to a community teaching hospital. Methods:We retrospectively reviewed laparoscopic liver resections performed between August 2010 and July 2013 at St. Joseph's Health Centre in Toronto. The primary outcomes were mortality, major morbidity and negative margins. Secondary outcomes included other perioperative outcomes. We used nonparametric tests to compare the outcomes during the first (group A) and second (group B) halves of the study period.Results: Group A included 19 patients and group B had 25 patients; 9 and 4 patients, respectively, had major resections. Group A had the only death due to liver failure. There was no difference in major complications (10.6% v. 16%) or length of stay (4.5 v. 4.6 d) between the groups. One patient in group B had a positive margin. There was a significant decrease in duration of surgery (from 237 to 170 min, p = 0.007), with a trend toward shorter duration for major resections (from 318 to 238 min, p = 0.07). Furthermore, more procedures were performed for malignancy in group B than group A (36.8% v. 84.0%, p = 0.001). Conclusion:Laparoscopic liver resection can be safely introduced into a Canadian community teaching hospital. Average duration of surgery decreased by 67 minutes despite a 2-fold increase in the number of cases performed for malignancy. Résultats : Le groupe A incluait 19 patients et le groupe B, 25 patients; 9 et 4 patients, respectivement, ont subi des résections majeures. Le groupe A a enregistré le seul décès attribuable à une insuffisance hépatique. On n'a noté aucune différence quant aux complications majeures (10,6 % c. 16 %) ou quant à la durée de l'hospitalisation (4,5 c. 4,6 jours) entre les groupes. Un patient du groupe B a présenté une marge positive. On a noté en général une diminution significative de la durée de l'intervention (de 237 à 170 minutes, p = 0,007); dans le cas des résections majeures, on a noté une tendance à la diminution de la durée de l'intervention (de 318 à 238 mi nutes, p = 0,07). En outre, un plus grand nombre d'interventions ont été effectuées pour des cas de cancer dans le groupe B que dans le groupe A (36,8 % c. 84,0 %, p = 0,001). Conclusion :La résection hépatique laparoscopique peut être pratiquée de manière sécuritaire dans un hôpital d'enseignement communautaire canadien. La durée moyenne des interventions a diminué de 67 minutes, malgré une augmentation du double du nombre d'interventions effectuées pour des cas de cancer.

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“…This sudden proliferation concerns mainly minor hepatectomies (resection of less than 3 segments), and, until recently, only sporadic reports of major laparoscopic liver resections existed [3,4,6,9,[12][13][14]. In 2009, a multicenter international study by Dagher et al [10] of 210 major liver resections using laparoscopy, demonstrated that laparoscopic major hepatectomies are feasible in selected patients, when performed by experienced surgeons.…”

Section: Discussionmentioning

confidence: 99%

European experience of laparoscopic major hepatectomy

Tzanis

Shivathirthan

Laurent

et al. 2012

J Hepato Biliary Pancreat

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Background/purpose Laparoscopic hepatectomies have seen a worldwide proliferation. Major anatomic resections, which were initially considered unsuitable for laparoscopy, are currently confined to a few centers of expertise. The aim of this study was to discuss the current trends and techniques in laparoscopic major hepatectomy in Europe. Methods The prospective databases of ten European centers were combined to provide answers to a questionnaire that had been addressed to all European teams known to perform laparoscopic liver surgery. Results Between 1996 and 2011 a total of 2245 laparoscopic liver resections have been carried out, of which 495 (22 %) were major resections. The proportion of laparoscopic right and left hepatectomies varied between 4 and 40 % of all major hepatectomies of the same type. Benign, primary malignant and metastatic lesions were, respectively, 22.4, 19.6 and 58 % of all indications. The different techniques and approaches, as regards hand assistance, hepatic inflow and outflow control, liver mobilization and concomitant colectomies, are discussed. Conclusions To date, an important level of experience of laparoscopic liver resection has been accumulated in Europe, and experience of major hepatectomies is constantly increasing. However, they remain technically very demanding procedures which should be confined to expert surgeons who have already acquired considerable experience with simpler laparoscopic liver resections.

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Laparoscopic right hepatectomy:

Cited by 216 publications

References 14 publications

Laparoscopic hepatic left lateral lobectomy combined with fi ber choledochoscopic exploration of the common bile duct and traditional open operation

Laparoscopic hepatic left lateral lobectomy combined with fi ber choledochoscopic exploration of the common bile duct and traditional open operation

Starting a new laparoscopic liver surgery program: initial experience and improved efficiency

European experience of laparoscopic major hepatectomy

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