Laparoscopic Major Hepatectomy—Technique and Outcomes

Senthilnathan, Palanisamy; Sabnis, Sandeep C; Patel, Nikunj; Nalankilli, V.P.; Vijai, Anand; Palanivelu, Praveen Raj; Ramkrishnan, Parthasarthi; Palanivelu, Chinnusamy

doi:10.1007/s11605-015-2933-x

Cited by 22 publications

(23 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, anatomical resection is preferred when performing curative resection for HCC in patients with good functional liver reserve 85. As the number of LLR cases increases, so, too, does the number of reports on major LLR 86, 87. The evidence indicates that LLR is safe when performed by surgeons with sufficient experience.…”

Section: Indications and Oncological Outcomesmentioning

confidence: 99%

Evolution and revolution of laparoscopic liver resection in Japan

Kaneko

Otsuka

Kubota

et al. 2017

Annals of Gastroent Surgery

View full text Add to dashboard Cite

Due to important technological developments and improved endoscopic techniques, laparoscopic liver resection (LLR) is now considered the approach of choice and is increasingly performed worldwide. Recent systematic reviews and meta‐analyses of observational data reported that LLR was associated with less bleeding, fewer complications, and no oncological disadvantage; however, no prospective randomized trials have been conducted. LLR will continue to evolve as a surgical approach that improves patient's quality of life. LLR will not totally supplant open liver surgery, and major LLR remains to be technically challenging procedure. The success of LLR depends on individual learning curves and adherence to surgical indications. A recent study proposed a scoring system for stepwise application of LLR, which was based on experience at high‐volume Japanese centers. A cluster of deaths after major LLR was sensationally reported by the Japanese media in 2014. In response, the Japanese Society of Hepato‐Biliary‐Pancreatic Surgery conducted emergency data collection on operative mortality. The results demonstrated that mortality was not higher than that for open procedures except for hemi‐hepatectomy with biliary reconstruction. An online prospective registry system for LLR was established in 2015 to be transparent for patients who might potentially undergo treatment with this newly developed, technically demanding surgical procedure.

show abstract

Section: Indications and Oncological Outcomesmentioning

confidence: 99%

Evolution and revolution of laparoscopic liver resection in Japan

Kaneko

Otsuka

Kubota

et al. 2017

Annals of Gastroent Surgery

View full text Add to dashboard Cite

show abstract

“…According to the Second International Consensus Conference for Laparoscopic Liver Resection, minor liver resections, such as left lateral sectionectomy, have become a standard practice, while laparoscopic major liver resections remain in an exploration phase . Furthermore, reports on laparoscopic major hepatectomy from various centers have showed controversial short‐ and long‐term outcomes …”

Section: Introductionmentioning

confidence: 99%

Robotic vs laparoscopic hemihepatectomy: A comparative study from a single center

Wang

Tang

et al. 2019

Journal of Surgical Oncology

View full text Add to dashboard Cite

Background: Robotic surgery is increasingly being used in hepatectomy. Previous studies comparing the robotic and laparoscopic minor hepatectomy have been documented, but comparative studies on robotic and laparoscopic hemihepatectomy (LH) involving a large patient cohort are rare. The objective of this study was to compare perioperative outcomes between robotic and LH.Methods: Data on the demographics, clinicopathologic characteristics, and perioperative outcomes of consecutive patients who underwent robotic or LH in a single center between November 2011 and July 2017 were analyzed.Results: A total of 92 patients underwent robotic and 48 LH. Multiple linear regression analysis showed no significant difference in perioperative outcomes including operative time, postoperative hospital stay, postoperative complications, and mortality between the groups. Compared to the laparoscopic cohort, the robotic cohort had a significantly less estimated blood loss (120.24 mL; 95% confidence interval, 53.72-186.76) and a significantly lower conversation rate (1.09% vs 10.42%; P = .034). Stratified and interaction analyses demonstrated that disease type had an interaction effect on the association between the operative approach and the estimated blood loss.Conclusions: Robotic hemihepatectomy was safe and feasible in selected patients.It had similar perioperative outcomes as LH and was better than LH regarding estimated blood loss and open conversion.

show abstract

“…Benefits of laparoscopic resection include less blood loss, smaller incisions, decreased postoperative morbidity, and shorter length of stay compared to open liver resection (OLR) . With increased experience, several centers have reported large series of laparoscopic major hepatectomy , although significant controversy remains concerning indications, techniques, learning curve, risks, and long‐term cancer outcomes with laparoscopic major hepatectomy.…”

mentioning

confidence: 99%

“…The definitions aside, there have been a fair number of large series reporting laparoscopic major hepatectomy in the past 8 years . In 2009, an international multi‐center series reported 210 laparoscopic major hepatectomies among six high volume HPB Centers .…”

mentioning

confidence: 99%

Evidence supporting laparoscopic major hepatectomy

Cheek

Sucandy

Tsung

et al. 2016

J Hepato Biliary Pancreat

View full text Add to dashboard Cite

Laparoscopic liver resection (LLR) has been increasing in frequency with over 9,000 cases done worldwide. Benefits of laparoscopic resection include less blood loss, smaller incisions, decreased postoperative morbidity, and shorter length of stay compared to open liver resection. With increased experience, several centers have reported series of laparoscopic major hepatectomy, although this represents only about 25% of total LLR performed. Evidence is accumulating to support laparoscopic major hepatectomy with the understanding that there is a steep learning curve, and surgeons should begin with minor LLR before moving on to laparoscopic major hepatectomy. Controversy still remains concerning indications, techniques, learning curve, risks, and long-term cancer outcomes with laparoscopic major hepatectomy.

show abstract

Laparoscopic Major Hepatectomy—Technique and Outcomes

Abstract: Laparoscopic major liver resection is a formidable task. It requires considerable expertise in both, advanced laparoscopy, and liver surgery. It can be feasible, safe, and oncologically adequate in well-selected cases in experience hands.

Cited by 22 publications

References 24 publications

Evolution and revolution of laparoscopic liver resection in Japan

Evolution and revolution of laparoscopic liver resection in Japan

Robotic vs laparoscopic hemihepatectomy: A comparative study from a single center

Evidence supporting laparoscopic major hepatectomy

Contact Info

Product

Resources

About