Laparoscopic hepatobiliary and pancreatic surgery: an overview |
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Authors: | Mori Toshiyuki Abe Nobutsugu Sugiyama Masanori Atomi Yutaka |
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Institution: | (1) First Department of Surgery, 6-20-2 Shinkawa, Mitaka, 181-8611 Tokyo, Japan, JP |
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Abstract: | Although they are not widely employed, advanced laparoscopic hepatobiliary pancreatic (HBP) procedures can be performed.
Laparoscopic common bile duct (CBD) exploration has gained wide acceptance, and endoscopic retro-grade cholangiopancreatography/endoscopic
sphincterotomy (ERCP/ES) may become less important in the treatment of CBD stones. Choledochal cyst is another example that
is suitable for laparoscopic treatment. It can be removed, and bilioenteric flow is reestablished laparoscopically. Simple
cyst of the liver is an excellent indication for laparoscopic surgery. Cysts are unroofed, and recurrence is rare. Hydatid
disease can also be treated laparoscopically. In liver resection, the use of laparoscopy is limited to wedge resection and
left lateral segmentectomy at most. Laparoscopic staging for pancreatic cancer can demonstrate respectability in 90% of cases.
This staging may obviate unnecessary laparotomy. Although laparoscopic Whipple is feasible, laparoscoic distal pancreatectomy
is a realistic indication for pancreatic resection. Laparoscopic distal pancreatectomy may be indicated for cystic neoplasms
of low-grade malignancy, and for islet cell tumors. When internal drainage is indicated, pseudocysts can be treated laparoscopically.
If the cyst is located close to the posterior gastric wall, cystgastrostomy can also be achieved with an endoluminal surgical
technique.
Received: March 25, 2002 / Accepted: April 14, 2002
Offprint requests to: T. Mori |
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Keywords: | Laparoscopic biliary surgery Laparoscopic hepatic surgery Laparoscopic pancreatic surgery |
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