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Laparoscopic hepatectomy is theoretically better than open hepatectomy: preparing for the 2nd I nternational C onsensus C onference on L aparoscopic L iver R esection
Author(s) -
Wakabayashi Go,
Cherqui Daniel,
Geller David A.,
Han HoSeong,
Kaneko Hironori,
Buell Joseph F.
Publication year - 2014
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.139
Subject(s) - hepatectomy , medicine , pneumoperitoneum , laparoscopy , surgery , general surgery , resection
Six years have passed since the first International C onsensus C onference on L aparoscopic L iver R esection was held. This comparatively new surgical technique has evolved since then and is rapidly being adopted worldwide. We compared the theoretical differences between open and laparoscopic liver resection, using right hepatectomy as an example. We also searched the C ochrane L ibrary using the keyword “laparoscopic liver resection.” The papers retrieved through the search were reviewed, categorized, and applied to the clinical questions that will be discussed at the 2nd C onsensus C onference. The laparoscopic hepatectomy procedure is more difficult to master than the open hepatectomy procedure because of the movement restrictions imposed upon us when we operate from outside the body cavity. However, good visibility of the operative field around the liver, which is located beneath the costal arch, and the magnifying provide for neat transection of the hepatic parenchyma. Another theoretical advantage is that pneumoperitoneum pressure reduces hemorrhage from the hepatic vein. The literature search turned up 67 papers, 23 of which we excluded, leaving only 44. Two randomized controlled trials ( RCTs ) are underway, but their results are yet to be published. Most of the studies ( n = 15) concerned short‐term results, with some addressing long‐term results ( n = 7), cost ( n = 6), energy devices ( n = 4), and so on. Laparoscopic hepatectomy is theoretically superior to open hepatectomy in terms of good visibility of the operative field due to the magnifying effect and reduced hemorrhage from the hepatic vein due to pneumoperitoneum pressure. However, there is as yet no evidence from previous studies to back this up in terms of short‐term and long‐term results. The 2nd I nternational C onsensus C onference on L aparoscopic L iver R esection will arrive at a consensus on the basis of the best available evidence, with video presentations focusing on surgical techniques and the publication of guidelines for the standardization of procedures based on the experience of experts.