Laparoscopic right hepatectomy: a challenging, but feasible, safe and efficient procedure

Pearce, Neil; Fabio, Francesco Di; Teng, Mabel; Syed, Shareef; Primrose, John; Hilal, Mohammed Abu

doi:10.1016/j.amjsurg.2010.08.032

Cited by 70 publications

(37 citation statements)

References 26 publications

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“…These results are consistent with conversion rates reported for both minor laparoscopic liver resections for favorably located lesions and laparoscopic major hepatectomies. [17][18][19] In addition, we report 0% mortality and low postoperative complication rate (12.5%) to confirm the feasibility and safety of LapPSLRs in this setting. Bleeding and bile leak are commonly feared complications in liver surgery, especially in central resections.…”

Section: Discussionmentioning

confidence: 58%

Laparoscopic Parenchymal-Sparing Resections for Nonperipheral Liver Lesions, the Diamond Technique: Technical Aspects, Clinical Outcomes, and Oncologic Efficiency

Cipriani

Shelat

Rawashdeh

et al. 2015

Journal of the American College of Surgeons

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Section: Discussionmentioning

confidence: 58%

Laparoscopic Parenchymal-Sparing Resections for Nonperipheral Liver Lesions, the Diamond Technique: Technical Aspects, Clinical Outcomes, and Oncologic Efficiency

Cipriani

Shelat

Rawashdeh

et al. 2015

Journal of the American College of Surgeons

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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%

“…This can be attributed to the complexity of the procedures and fear of uncontrolled hemorrhage, combined with high-level technical demands and lack of training opportunities for most surgeons. However, progress in technology and better understanding of hepatic and minimally invasive surgery have resulted in some reports of medium-sized series of major laparoscopic hepatectomies with encouraging results [6,8,9].…”

Section: Introductionmentioning

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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“…While the open approach is associated with more blood loss and longer recovery time, LH allows for the perception of finer detail which leads to less invasiveness. Moreover, numerous randomized controlled trial (RCT) reports and meta-analyses have demonstrated that laparoscopic liver surgery for patients with HCC could achieve short-term and longterm outcomes comparable to case-matched open liver surgery (Koffron et al, 2007;Pearce et al, 2011;Rao et al, 2012). In all LH techniques, total LH provides better cosmetic results, less blood loss, and fewer hospitalization days in comparison.…”

Section: Introductionmentioning

confidence: 99%

Comparison of laparoscopic hepatectomy, percutaneous radiofrequency ablation and open hepatectomy in the treatment of small hepatocellular carcinoma

Lai

Jin

Liang

et al. 2016

J. Zhejiang Univ. Sci. B

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Abstract:Objective: Three mainstream techniques-laparoscopic hepatectomy (LH), percutaneous radiofrequency ablation (pRFA), and open hepatectomy (OH)-were compared in this study, in terms of their efficacies in the treatment of small hepatocellular carcinoma (HCC). Methods: A comparative study was performed within a total of 94 patients diagnosed with small HCC in our hospital from 2005 to 2010, who underwent LH (28), RFA (33), or OH (33). They had either a single tumor lesion of less than 5 cm or up to three nodules with diameters of less than 3 cm each. Outcomes were carefully evaluated throughout a 3-year follow-up interval and statistically interpreted. Results: The pRFA group had a significantly lower disease-free survival rate compared with the two surgical groups (P=0.001) and significantly shorter overall survival (P=0.005), while the LH group and the OH group had no difference in survival results. For patients younger than 60 years old, surgical approaches offered a better long-term overall survival prognosis (P=0.008). There were no statistically significant differences among the three groups in overall survival for elderly patients (P=0.104). Conclusions: Among patients with small HCC, LH may provide better curative effects than pRFA without increasing complication rates. pRFA leads to faster recurrence than surgical resections. LH has similar therapeutic effects to OH and causes less trauma. For patients younger than 60 years old, LH may be the best curative treatment. Elderly patients may choose either surgery or pRFA.

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Laparoscopic right hepatectomy: a challenging, but feasible, safe and efficient procedure

Cited by 70 publications

References 26 publications

Laparoscopic Parenchymal-Sparing Resections for Nonperipheral Liver Lesions, the Diamond Technique: Technical Aspects, Clinical Outcomes, and Oncologic Efficiency

Laparoscopic Parenchymal-Sparing Resections for Nonperipheral Liver Lesions, the Diamond Technique: Technical Aspects, Clinical Outcomes, and Oncologic Efficiency

European experience of laparoscopic major hepatectomy

Comparison of laparoscopic hepatectomy, percutaneous radiofrequency ablation and open hepatectomy in the treatment of small hepatocellular carcinoma

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