Laparoscopic approach to a planned two‐stage hepatectomy for bilobar colorectal liver metastases

Abstract

Laparoscopic first-stage resection of tumours in the left liver can be safely combined with RPVL/RPVE to achieve adequate hypertrophy of the FLR, allowing subsequent right hepatectomy.

Long-term survival in laparoscopic vs open resection for colorectal liver metastases: inverse probability of treatment weighting using propensity scores

“…If the projected remnant liver was less than 30% of total liver volume, if the risk of postoperative liver insufficiency was high, or if patients had resectable bilobar disease, portal vein embolisation or ligation, and/or 2-step staged hepatectomy was used. 18…”

Minimally-invasive 2-Stage Liver Resection with Portal Vein Ligation for Bi-Lobar Colorectal Liver Metastases

“…Many studies report favorable outcomes after open two stage hepatectomies (TSH) for bi-lobar colorectal liver metastases (10,11) and more recently some authors have described a MIS approach to TSH (12,13). Fuks et al reported acceptable short-term outcomes such as a low conversion rate, minimal blood loss and low morbidity rates in their series of 26 patients who underwent a pure laparoscopic approach for TSH (12).…”

“…Kilburn et al describe a laparoscopic 1st stage and open 2nd stage approach to patients with bi-lobar colorectal liver metastases. The authors describe a benefit of fewer adhesions at the 2 nd stage operation with this approach.Furthermore, they added that laparoscopic portal vein ligation during the first stage was feasible and can save the patient a separate portal embolization procedure (13).…”

Dealing with an insufficient future liver remnant: Portal vein embolization and two‐stage hepatectomy

“…Laparoscopic liver resection has been increasingly performed due to its advantages over open liver resection, in terms of better surgical and postoperative outcomes in selected patients . Some case series reported the feasibility of two‐stage hepatectomy using laparoscopic approach . Each group used different procedures such as a laparoscopic first‐stage liver resection followed by an open second‐stage hepatectomy, laparoscopic first‐ and second‐stage hepatectomy, and etc.…”

“…85,86 Some case series reported the feasibility of two-stage hepatectomy using laparoscopic approach. [87][88][89] Each group used different procedures such as a laparoscopic first-stage liver resection High grade SOS was associated with more postoperative morbidity.…”