Safety and Efficacy of Laparoscopic Caudate Lobectomy: A Systematic Review

Dorovinis, Panagiotis; Machairas, Nikolaos; Kykalos, Stylianos; Stamopoulos, Paraskevas; Vernadakis, Spiridon; Sotiropoulos, Georgios C.

doi:10.3390/jcm10214907

Cited by 12 publications

(4 citation statements)

References 46 publications

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“…However, for complex liver surgery, widespread application of laparoscopic surgery remains a significant challenge [ 19 – 21 ]. A few limitations of laparoscopic hepatectomy have been described.…”

Section: Introductionmentioning

confidence: 99%

Robotic versus laparoscopic major hepatectomy for hepatocellular carcinoma: short-term outcomes from a single institution

Liu

Wang

et al. 2022

BMC Surg

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Background Currently, an increasing number of robotic major hepatectomies for hepatocellular carcinoma (HCC) are being performed. Despite the advantages of robotic surgery over laparoscopic procedures, studies comparing robotic with laparoscopic major hepatectomy in terms of short-term results remain scarce. This study was performed to compare robotic major hepatectomy and laparoscopic major hepatectomy in terms of their intraoperative and postoperative results. Methods Data regarding demographics and intraoperative and postoperative results of 131 patients undergoing robotic or laparoscopic major hepatectomy between January 2017 and March 2022 were retrieved from their medical records and compared between the two types of surgery. Results Between January 2017 and March 2022, 44 robotic major hepatectomies and 87 laparoscopic major hepatectomies were performed at the Department of Hepatobiliary and Pancreatic Surgery, Shenzhen People’s Hospital. Patients undergoing robotic major hepatectomy were not significantly different from those undergoing laparoscopic major hepatectomy in terms of age (P = 0.397), sex (P = 0.624), body mass index (BMI) (P = 0.118), alpha-fetoprotein (AFP) (P = 0.09), tumor size (P = 0.176), cirrhosis (P = 0.384), fatty liver (P = 0.162), preoperative antiviral treatment (P = 0.934), hepatitis B virus (HBV) DNA (P = 0.646) and operation type (P = 0.054). Robotic major hepatectomy was associated with a longer operation time (median: 255.5 versus 206.8 min; P < 0.001) and less estimated blood loss (median: 118.9 versus 197.0 ml; P = 0.002) than laparoscopic major hepatectomy. However, robotic major hepatectomy was not significantly different from laparoscopic major hepatectomy regarding length of postoperative hospital stay (P = 0.849), open conversion (P = 0.077), ICU stay (P = 0.866), postoperative massive abdominal bleeding (P = 1.00), portal vein thrombosis (P = 1.00), abdominal infection (P = 1.00), pulmonary infection (P = 1.00), pulmonary embolism (P = 1.00), cardiac complications (P = 1.00), liver failure (P = 1.00), kidney failure (P = 1.00), biliary leak (P = 1.00), positive resection margin (P = 1.00), 30-day mortality (P = 1.00) and 90-day mortality (P = 1.00). Conclusions Robotic major hepatectomy was as effective as laparoscopic surgery in terms of intraoperative and postoperative results but took longer and could more efficiently control intraoperative blood loss.

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Section: Introductionmentioning

confidence: 99%

Robotic versus laparoscopic major hepatectomy for hepatocellular carcinoma: short-term outcomes from a single institution

Liu

Wang

et al. 2022

BMC Surg

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“…In addition, a tumor-free margin greater than 10 mm contributes to better survival benefits. LRRHCCA combined with total CLR is more convenient, but the operation time is relatively long and has high technical requirements, which need to be completed by experienced laparoscopic doctors 68 .…”

Section: Discussionmentioning

confidence: 99%

The value of total caudate lobe resection for hilar cholangiocarcinoma

Wang,

Xiong,

et al. 2023

International Journal of Surgery

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Hilar cholangiocarcinoma is widely considered to have poor prognosis. In particular, combined caudate lobe resection (CLR) as a strategy for radical resection in hilar cholangiocarcinoma is important for improving the R0 resection rate. However, the criteria for R0 resection, necessity of CLR, optimal extent of hepatic resection, and surgical approach are still controversial. This review aimed to summarize the findings and discuss the controversies surrounding caudate lobe resection. Numerous clinical studies have shown that combined CLR treatment for hilar cholangiocarcinoma improves the R0 resection rate and postoperative survival time. Whether surgery for Bismuth type I or II is combined with CLR depends on the pathological type. Considering the anatomical factors, total rather than partial caudate lobe resection is recommended to achieve a higher R0 resection rate. In the resection of hilar cholangiocarcinoma, a proximal ductal margin ≥ 10 mm should be achieved to obtain a survival benefit. Although there is no obvious boundary between the right side (especially the paracaval portion) and right posterior lobe of the liver, Peng’s resection line can serve as a reference marker for right-sided resection. Laparoscopic resection of the caudate lobe may be safer, more convenient, accurate, and minimally invasive than open surgery, but it needs to be completed by experienced laparoscopic doctors.

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“…Due to its anatomical location, the caudate lobe is often involved in hepatobiliary pathologies, including hepatocellular carcinoma, cholangiocarcinoma, and hepatolithiasis. Consequently, its precise assessment and management are crucial for achieving successful outcomes in anatomical hepatectomy [3]. Based on the anatomical study by Kogure et al, the caudate portal vein may originate from the left branch, bifurcation, right branch, or right posterior branch of the portal vein [4].…”

Section: Introductionmentioning

confidence: 99%

Caudate lobe-based minimally invasive anatomic hepatectomy: a retrospective study

Zhang,

Peng,

Zhu

et al. 2023

Preprint

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Background: Anatomic hepatectomy has become a crucial surgical procedure in the liver section. The function and role of the caudate lobe in anatomic hepatectomy remain unclear. Thus, this study aimed to summarize the efficiency of caudate lobe-based anatomic hepatectomy. Methods: Three hundred thirty-one cases were enrolled in this retrospective study. They underwent minimally invasive hepatectomy based on caudate lobe-based anatomic hepatectomy theory. The operation time, blood loss, postoperative CRP, and hospital duration were collected for further analysis. Results: The mean length of G1L was longer than that of G1C. The length of G1C or G1L was negatively correlated with clinical outcomes (bleeding volume, operation time, postoperative CRP, and hospital duration) and the occurrence of operation-associated complications. Further subgroup analysis showed that theclinical outcomes (postoperative CRP and bleeding volume) of patients who underwent right hepatectomy were negatively associated with the length of the G1C, and the length of the G1L wasconnected to the clinical outcome of patients after left hepatectomy. Conclusion: Based on the outcomes of 331 patientsundergoing hepatectomy, caudate lobe-based anatomic hepatectomy theory was feasible and efficient for anatomic liver sections.

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Safety and Efficacy of Laparoscopic Caudate Lobectomy: A Systematic Review

Cited by 12 publications

References 46 publications

Robotic versus laparoscopic major hepatectomy for hepatocellular carcinoma: short-term outcomes from a single institution

Robotic versus laparoscopic major hepatectomy for hepatocellular carcinoma: short-term outcomes from a single institution

The value of total caudate lobe resection for hilar cholangiocarcinoma

Caudate lobe-based minimally invasive anatomic hepatectomy: a retrospective study

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