Laparoscopic versus open left lateral hepatectomy

Abstract

Laparoscopic liver surgery is becoming more popular, and many high-volume liver centers are now gaining expertise in this area. Laparoscopic left lateral hepatectomy (LLLH) is a standardized and anatomically well-defined resection and may transform into a primarily laparoscopic procedure for cancer surgery or living donor hepatectomy for transplantation. Five case-control series were identified comparing a total of 167 cases (86 cases of LLLH plus 81 cases of open left lateral hepatectomy). Groups were matched by age and sex, with broadly similar indications for surgery and resection techniques. LLLH is associated with shorter hospital stays and less blood loss without compromising the margin status or increasing complication rates. Donors of LLLH grafts did not have higher graft-related morbidity. Prospective studies are required to define the safety in terms of disease-free and overall survival in this new avenue in laparoscopic liver surgery.

Evolution of laparoscopic left lateral sectionectomy without the Pringle maneuver: through resection of benign and malignant tumors to living liver donation

“…The development of this technique has been limited during this time due to difficulty reproducing basic open liver surgery maneuvers, risks of bleeding and pulmonary embolism, and fear of compromising oncologic resection by tumoral cell seeding [20, 21]. …”

Stepwise introduction of laparoscopic liver surgery: validation of guideline recommendations

“…[1][2][3][4][5][6][7][8][9] Benefits of LLS include less intraoperative blood loss, less postoperative complications, decreased need for analgesics, faster functional recovery, shorter postoperative stay, and a cosmetic benefit. [1][2][3][4][5][6][7][8][9] In addition, some studies have demonstrated the cost-effectiveness of LLS, [10][11][12] thus resulting in benefits for both individual patients and healthcare institutions. These promising results have promptly increased the interest in LLS worldwide 1,2 and the first randomized controlled trials of laparoscopic vs. open liver surgery have been performed.…”

Surgical and oncologic outcomes following laparoscopic versus open liver resection for hepatocellular carcinoma: A meta‐analysis

“…However, the conclusions only represent a small group of patients. Moreover, the oncologic risks of laparoscopic liver resection for HCC are still under investigation, especially the surgery resection margin, the potential for tumor cell seeding through trocar‐site or peritoneal dissemination and tumor recurrence 13 . This study aims to use meta‐analysis of comparative studies to dig deeper on the aspect of surgical and oncologic outcomes of patients with HCC undergoing laparoscopic versus open hepatectomy.…”