Laparoscopic Liver Resection (LLR): state of the art
| Autor: | Martine Goergen, J.S. Azagra, V. Lens, M. Schiltz, Jean-François Gigot |
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| Rok vydání: | 2006 |
| Předmět: | |
| Zdroj: | European Surgery. 38:378-383 |
| ISSN: | 1682-4016 1682-8631 |
| DOI: | 10.1007/s10353-006-0289-x |
| Popis: | BACKGROUND: The purpose of this review is to define "state of the art" in laparoscopic liver resection (LLR), define the role of laparoscopy and intra-operative ultrasonography (IOUS) for optimization of the radiological diagnosis and its impact on indications, patient selection and improvement of procedure safety. Finally we aim to address economic and surgical technical issues, i.e. learning curve, conversion rate, and comparison to open technique. METHODS: Review on laparoscopic liver resection (LLR), we have only included studies reporting more than 10 liver resections. RESULTS: 17 series including 595 patients are considered. No deaths are reported and the morbidity indicated as mean of postoperative complications is low: 15.5% (range: 4.7–45). The mean conversion rate is 8.5% (range: 0–54.5%). The mean of patients transfused is 8.6% (range: 0–35%) and the reinterventions 1.06%. Surgical margins are invaded in 0.79% (range: 0–7%) but no port side metastases are observed. CONCLUSIONS: A review of literature confirms the feasibility of LLR in selected patients with small anterior tumours in 90%, a lesser morbidity rate even if perioperative blood loss is identical. A longer operative time is compensated by a shorter hospital stay. In malignant disease, IOUS and hand assisted laparoscopic surgery are of great importance to get adequate surgical margin. |
| Databáze: | OpenAIRE |
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