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European experience of laparoscopic major hepatectomy |
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| Authors: | Dimitrios Tzanis Nairuthya Shivathirthan Alexis Laurent Mohammad Abu Hilal Olivier Soubrane Airazat M. Kazaryan Giuseppe Maria Ettore Ronald M. Van Dam Panagiotis Lainas Hadrien Tranchart Bjorn Edwin Giulio Belli Ricardo Robles Campos Neil Pearce Brice Gayet Ibrahim Dagher |
| Affiliation: | 1. Department of Digestive and Minimally Invasive Surgery, AP-HP, Antoine Béclère Hospital, 157 rue de la Porte de, Trivaux, 92141, Clamart Cedex, France 2. Department of Digestive Diseases, Montsouris Institute, 75014, Paris, France 3. Department of Digestive and Hepatobiliary Surgery and Liver Transplantation, AP-HP, Henri-Mondor Hospital, 94010, Créteil, France 4. Hepatobiliary-Pancreatic and Laparoscopic Surgical Unit, Southampton General Hospital, Southampton University Hospitals, NHS Trust, Southampton, UK 5. Department of Hepatobiliary Surgery and Liver Transplantation, AP-HP, Saint-Antoine Hospital, 75012, Paris, France 6. Department of Hepatopancreatobiliary and Gastrointestinal Surgery, Intervention Centre, Oslo University Hospital-Rikshospitalet, Oslo, Norway 7. General Surgery and Transplantation Unit, San Camillo Hospital, Rome, Italy 8. HPB, Minimal Access and Robotic Surgery, Maastricht University Medical Center, Maastricht, The Netherlands 9. Department of General and Hepato-Pancreato-Biliary Surgery, S.M. Loreto Nuovo Hospital, Naples, Italy 10. Department of Hepatobiliary Surgery and Liver Transplantation, University Hospital Virgen de la Arrixaca, El Palmar, Murcia, Spain 11. Paris-Sud University, 91405, Orsay, France |
| Abstract: | Background/purposeLaparoscopic hepatectomies have seen a worldwide proliferation. Major anatomic resections, which were initially considered unsuitable for laparoscopy, are currently confined to a few centers of expertise. The aim of this study was to discuss the current trends and techniques in laparoscopic major hepatectomy in Europe.MethodsThe prospective databases of ten European centers were combined to provide answers to a questionnaire that had been addressed to all European teams known to perform laparoscopic liver surgery.ResultsBetween 1996 and 2011 a total of 2245 laparoscopic liver resections have been carried out, of which 495 (22 %) were major resections. The proportion of laparoscopic right and left hepatectomies varied between 4 and 40 % of all major hepatectomies of the same type. Benign, primary malignant and metastatic lesions were, respectively, 22.4, 19.6 and 58 % of all indications. The different techniques and approaches, as regards hand assistance, hepatic inflow and outflow control, liver mobilization and concomitant colectomies, are discussed.ConclusionsTo date, an important level of experience of laparoscopic liver resection has been accumulated in Europe, and experience of major hepatectomies is constantly increasing. However, they remain technically very demanding procedures which should be confined to expert surgeons who have already acquired considerable experience with simpler laparoscopic liver resections. |
| Keywords: | laparoscopy major hepatectomy right hepatectomy left hepatectomy |
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