European experience of laparoscopic major hepatectomy

Journal of Hepato-Biliary-Pancreatic Sciences - Tập 20 - Trang 120-124 - 2012
Dimitrios Tzanis1, Nairuthya Shivathirthan2, Alexis Laurent3, Mohammad Abu Hilal4, Olivier Soubrane5, Airazat M. Kazaryan6, Giuseppe Maria Ettore7, Ronald M. Van Dam8, Panagiotis Lainas1, Hadrien Tranchart1, Bjorn Edwin6, Giulio Belli9, Ricardo Robles Campos10, Neil Pearce4, Brice Gayet2, Ibrahim Dagher1,11
1Department of Digestive and Minimally Invasive Surgery, AP-HP, Antoine Béclère Hospital, Clamart Cedex, France
2Department of Digestive Diseases, Montsouris Institute, Paris, France
3Department of Digestive and Hepatobiliary Surgery and Liver Transplantation, AP-HP, Henri-Mondor Hospital, Créteil, France
4Hepatobiliary-Pancreatic and Laparoscopic Surgical Unit, Southampton General Hospital, Southampton University Hospitals NHS Trust, Southampton, UK
5Department of Hepatobiliary Surgery and Liver Transplantation, AP-HP, Saint-Antoine Hospital, Paris, France
6Department of Hepatopancreatobiliary and Gastrointestinal Surgery, Intervention Centre, Oslo University Hospital-Rikshospitalet, Oslo, Norway
7General Surgery and Transplantation Unit, San Camillo Hospital, Rome, Italy
8HPB, Minimal Access and Robotic Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
9Department of General and Hepato-Pancreato-Biliary Surgery S.M. Loreto Nuovo Hospital Naples Italy
10Department of Hepatobiliary Surgery and Liver Transplantation, University Hospital Virgen de la Arrixaca, Murcia, Spain
11Paris-Sud University, Orsay, France

Tóm tắt

Laparoscopic 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. The 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. Between 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. To 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.

Tài liệu tham khảo

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