Minireview on laparoscopic hepatobiliary and pancreatic surgery

Abstract

The first laparoscopic cholecystectomy was performed in the mid-1980s. Since then, laparoscopic surgery has continued to gain prominence in numerous fields, and has, in some fields, replaced open surgery as the preferred operative technique. The role of laparoscopy in staging cancer is controversial, with regards to gallbladder carcinoma, pancreatic carcinoma, hepatocellular carcinoma and liver metastasis from colorectal carcinoma, laparoscopy in conjunction with intraoperative ultrasound has prevented nontherapeutic operations, and facilitated therapeutic operations. Laparoscopic cholecystectomy is the preferred option in the management of gallbladder disease. Meta-analyses comparing laparoscopic to open distal pancreatectomy show that laparoscopic pancreatectomy is safe and efficacious in the management of benign and malignant disease, and have better patient outcomes. A pancreaticoduodenectomy is a more complex operation and the laparoscopic technique is not feasible for this operation at this time. Robotic assisted pancreaticoduodenectomy has been tried with limited success at this time, but with continuing advancement in this field, this operation would eventually be feasible. Liver resection remains to be the best management for hepatocellular carcinoma, cholangiocarcinoma and colorectal liver metastases. Systematic reviews and meta-analyses have shown that laparoscopic liver resections result in patients with equal or less blood loss and shorter hospital stays, as compared to open surgery. With improving equipment and technique, and the incorporation of robotic surgery, minimally invasive liver resection operative times will improve and be more efficacious. With the incorporation of robotic surgery into hepatobiliary surgery, donor hepatectomies have also been completed with success. The management of benign and malignant disease with minimally invasive hepatobiliary and pancreatic surgery is safe and efficacious.

Laparoscopic pancreatic resections: review of feasibility, safety and outcome

“…Laparoscopic pancreatic resections pose a challenging learning curve (2,5,6,8). Due to it's complexity LPD and LAPD are more challenging than LDP (8).…”

“…The duration of surgery compared to open, is more in Laparoscopic pancreaticoduodenectomy(LPD) (2) whilst similar in distal resections (9). The learning curve is less steeper for distal resections (6).…”

Is Gall-Bladder Polyp Equivalent to Cancer? An Analysis of Material From 1196 Cholecystectomies - A Comparison of the Ultrasound and Histopathological Results

“…a history of multiple surgical procedures in the epigastrium) classic cholecystectomy should be performed. A suspected cancer lesion in the gallbladder should not be regarded as an a priori indication to open surgery (20). CONCLUSIONS 1.…”

Animal ethics in laparoscopic urology training

“…[1] Laparoscopic operating techniques are widely used as minimally invasive urological surgeries. Over time, in some operations this method has virtually become the gold standard method of surgical intervention.…”