Laparoscopic liver resection: A systematic review

Luca Viganò, Claude Tayar, Alexis Laurent, Daniel Cherqui

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Outcomes of laparoscopic liver resection (LLR) are not clarified. The objective of this article is to depict the state of the art of LLR by means of a systematic review of the literature. Methods: Studies about LLR published before September 2008 were identified and their results summarized. Results: Indications for laparoscopic hepatectomy do not differ from those for open surgery. Technical feasibility is the only limiting factor. Bleeding is the major intraoperative concern, but, if managed by an expert surgeon, do not worsen outcomes. Hand assistance can be useful in selected cases to avoid conversion. Patient selection must take both tumor location and size into consideration. Potentially good candidates are patients with peripheral lesions requiring limited hepatectomy or left lateral sectionectomy; their outcomes, including reduced blood loss, morbidity, and hospital stay, are better than those of their laparotomic counterparts. The same advantages have been observed in cirrhotics. Laparoscopic major hepatectomies and resections of postero-superior segments need further evaluation. The results of LLR in cancer patients seem to be similar to those obtained with the laparotomic approach, especially in cases of hepatocellular carcinoma, but further analysis is required. Conclusions: Laparoscopic liver resection is safe and feasible. The laparoscopic approach can be recommended for peripheral lesions requiring limited hepatectomy or left lateral sectionectomy. Preliminary oncological results suggest non-inferiority of laparoscopic to laparotomic procedures.

Original languageEnglish
Pages (from-to)410-421
Number of pages12
JournalJournal of Hepato-Biliary-Pancreatic Surgery
Volume16
Issue number4
DOIs
Publication statusPublished - Jun 2009

Keywords

  • Laparoscopic liver resection
  • Laparoscopic liver surgery
  • Laparoscopy
  • Liver resection
  • Liver surgery
  • Review

ASJC Scopus subject areas

  • Surgery
  • Hepatology

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