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Article: Position on laparoscopic liver surgery

TitlePosition on laparoscopic liver surgery
Authors
Issue Date2009
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.com
Citation
Annals Of Surgery, 2009, v. 250 n. 5, p. 825-830 How to Cite?
AbstractObjective: To summarize the current world position on laparoscopic liver surgery. Summary Background Data: Multiple series have reported on the safety and efficacy of laparoscopic liver surgery. Small and medium sized procedures have become commonplace in many centers, while major laparoscopic liver resections have been performed with efficacy and safety equaling open surgery in highly specialized centers. Although the field has begun to expand rapidly, no consensus meeting has been convened to discuss the evolving field of laparoscopic liver surgery. Methods: On November 7 to 8, 2008, 45 experts in hepatobiliary surgery were invited to participate in a consensus conference convened in Louisville, KY, US. In addition, over 300 attendees were present from 5 continents. The conference was divided into sessions, with 2 moderators assigned to each, so as to stimulate discussion and highlight controversies. The format of the meeting varied from formal presentation of experiential data to expert opinion debates. Written and video records of the presentations were produced. Specific areas of discussion included indications for surgery, patient selection, surgical techniques, complications, patient safety, and surgeon training. Results: The consensus conference used the terms pure laparoscopy, handassisted laparoscopy, and the hybrid technique to define laparoscopic liver procedures. Currently acceptable indications for laparoscopic liver resection are patients with solitary lesions, 5 cm or less, located in liver segments 2 to 6. The laparoscopic approach to left lateral sectionectomy should be considered standard practice. Although all types of liver resection can be performed laparoscopically, major liver resections (eg, right or left hepatectomies) should be reserved for experienced surgeons facile with more advanced laparoscopic hepatic resections. Conversion should be performed for difficult resections requiring extended operating times, and for patient safety, and should be considered prudent surgical practice rather than failure. In emergent situations, efforts should be made to control bleeding before converting to a formal open approach. Utilization of a hand assist or hybrid technique may be faster, safer, and more efficacious. Indications for surgery for benign hepatic lesions should not be widened simply because the surgery can be done laparoscopically. Although data presented on colorectal metastases did not reveal an adverse effect of the laparoscopic approach on oncological outcomes in terms of margins or survival, adequacy of margins and ability to detect occult lesions are concerns. The pure laparoscopic technique of left lateral sectionectomy was used for adult to child donation while the hybrid approach has been the only one reported to date in the case of adult to adult right lobe donation. Laparoscopic liver surgery has not been tested by controlled trials for efficacy or safety. A prospective randomized trial appears to be logistically prohibitive; however, an international registry should be initiated to document the role and safety of laparoscopic liver resection. Conclusions: Laparoscopic liver surgery is a safe and effective approach to the management of surgical liver disease in the hands of trained surgeons with experience in hepatobiliary and laparoscopic surgery. National and international societies, as well as governing boards, should become involved in the goal of establishing training standards and credentialing, to ensure consistent standards and clinical outcomes.Copyright © 2009 by Lippincott Williams & Wilkins.
Persistent Identifierhttp://hdl.handle.net/10722/172992
ISSN
2023 Impact Factor: 7.5
2023 SCImago Journal Rankings: 2.729
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorBuell, JFen_US
dc.contributor.authorCherqui, Den_US
dc.contributor.authorGeller, DAen_US
dc.contributor.authorO'rourke, Nen_US
dc.contributor.authorIannitti, Den_US
dc.contributor.authorDagher, Ien_US
dc.contributor.authorKoffron, AJen_US
dc.contributor.authorThomas, Men_US
dc.contributor.authorGayet, Ben_US
dc.contributor.authorHan, HSen_US
dc.contributor.authorWakabayashi, Gen_US
dc.contributor.authorBelli, Gen_US
dc.contributor.authorKaneko, Hen_US
dc.contributor.authorKer, CGen_US
dc.contributor.authorScatton, Oen_US
dc.contributor.authorLaurent, Aen_US
dc.contributor.authorAbdalla, EKen_US
dc.contributor.authorChaudhury, Pen_US
dc.contributor.authorDutson, Een_US
dc.contributor.authorGamblin, Cen_US
dc.contributor.authorD'angelica, Men_US
dc.contributor.authorNagorney, Den_US
dc.contributor.authorTesta, Gen_US
dc.contributor.authorLabow, Den_US
dc.contributor.authorManas, Den_US
dc.contributor.authorPoon, RTen_US
dc.contributor.authorNelson, Hen_US
dc.contributor.authorMartin, Ren_US
dc.contributor.authorClary, Ben_US
dc.contributor.authorPinson, WCen_US
dc.contributor.authorMartinie, Jen_US
dc.contributor.authorVauthey, JNen_US
dc.contributor.authorGoldstein, Ren_US
dc.contributor.authorRoayaie, Sen_US
dc.contributor.authorBarlet, Den_US
dc.contributor.authorEspat, Jen_US
dc.contributor.authorAbecassis, Men_US
dc.contributor.authorRees, Men_US
dc.contributor.authorFong, Yen_US
dc.contributor.authorMcmasters, KMen_US
dc.contributor.authorBroelsch, Cen_US
dc.contributor.authorBusuttil, Ren_US
dc.contributor.authorBelghiti, Jen_US
dc.contributor.authorStrasberg, Sen_US
dc.contributor.authorChari, RSen_US
dc.date.accessioned2012-10-30T06:26:18Z-
dc.date.available2012-10-30T06:26:18Z-
dc.date.issued2009en_US
dc.identifier.citationAnnals Of Surgery, 2009, v. 250 n. 5, p. 825-830en_US
dc.identifier.issn0003-4932en_US
dc.identifier.urihttp://hdl.handle.net/10722/172992-
dc.description.abstractObjective: To summarize the current world position on laparoscopic liver surgery. Summary Background Data: Multiple series have reported on the safety and efficacy of laparoscopic liver surgery. Small and medium sized procedures have become commonplace in many centers, while major laparoscopic liver resections have been performed with efficacy and safety equaling open surgery in highly specialized centers. Although the field has begun to expand rapidly, no consensus meeting has been convened to discuss the evolving field of laparoscopic liver surgery. Methods: On November 7 to 8, 2008, 45 experts in hepatobiliary surgery were invited to participate in a consensus conference convened in Louisville, KY, US. In addition, over 300 attendees were present from 5 continents. The conference was divided into sessions, with 2 moderators assigned to each, so as to stimulate discussion and highlight controversies. The format of the meeting varied from formal presentation of experiential data to expert opinion debates. Written and video records of the presentations were produced. Specific areas of discussion included indications for surgery, patient selection, surgical techniques, complications, patient safety, and surgeon training. Results: The consensus conference used the terms pure laparoscopy, handassisted laparoscopy, and the hybrid technique to define laparoscopic liver procedures. Currently acceptable indications for laparoscopic liver resection are patients with solitary lesions, 5 cm or less, located in liver segments 2 to 6. The laparoscopic approach to left lateral sectionectomy should be considered standard practice. Although all types of liver resection can be performed laparoscopically, major liver resections (eg, right or left hepatectomies) should be reserved for experienced surgeons facile with more advanced laparoscopic hepatic resections. Conversion should be performed for difficult resections requiring extended operating times, and for patient safety, and should be considered prudent surgical practice rather than failure. In emergent situations, efforts should be made to control bleeding before converting to a formal open approach. Utilization of a hand assist or hybrid technique may be faster, safer, and more efficacious. Indications for surgery for benign hepatic lesions should not be widened simply because the surgery can be done laparoscopically. Although data presented on colorectal metastases did not reveal an adverse effect of the laparoscopic approach on oncological outcomes in terms of margins or survival, adequacy of margins and ability to detect occult lesions are concerns. The pure laparoscopic technique of left lateral sectionectomy was used for adult to child donation while the hybrid approach has been the only one reported to date in the case of adult to adult right lobe donation. Laparoscopic liver surgery has not been tested by controlled trials for efficacy or safety. A prospective randomized trial appears to be logistically prohibitive; however, an international registry should be initiated to document the role and safety of laparoscopic liver resection. Conclusions: Laparoscopic liver surgery is a safe and effective approach to the management of surgical liver disease in the hands of trained surgeons with experience in hepatobiliary and laparoscopic surgery. National and international societies, as well as governing boards, should become involved in the goal of establishing training standards and credentialing, to ensure consistent standards and clinical outcomes.Copyright © 2009 by Lippincott Williams & Wilkins.en_US
dc.languageengen_US
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.comen_US
dc.relation.ispartofAnnals of Surgeryen_US
dc.titlePosition on laparoscopic liver surgeryen_US
dc.typeArticleen_US
dc.identifier.emailPoon, RT: poontp@hkucc.hku.hken_US
dc.identifier.authorityPoon, RT=rp00446en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1097/SLA.0b013e3181b3b2d8en_US
dc.identifier.pmid19916210-
dc.identifier.scopuseid_2-s2.0-70449411205en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-70449411205&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume250en_US
dc.identifier.issue5en_US
dc.identifier.spage825en_US
dc.identifier.epage830en_US
dc.identifier.isiWOS:000208667400022-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridBuell, JF=7006642204en_US
dc.identifier.scopusauthoridCherqui, D=7005693719en_US
dc.identifier.scopusauthoridGeller, DA=7102287103en_US
dc.identifier.scopusauthoridO'Rourke, N=8049838900en_US
dc.identifier.scopusauthoridIannitti, D=6701415088en_US
dc.identifier.scopusauthoridDagher, I=24588700800en_US
dc.identifier.scopusauthoridKoffron, AJ=6603886387en_US
dc.identifier.scopusauthoridThomas, M=7404755763en_US
dc.identifier.scopusauthoridGayet, B=7006311829en_US
dc.identifier.scopusauthoridHan, HS=7401969217en_US
dc.identifier.scopusauthoridWakabayashi, G=35453095200en_US
dc.identifier.scopusauthoridBelli, G=7004998933en_US
dc.identifier.scopusauthoridKaneko, H=7401784831en_US
dc.identifier.scopusauthoridKer, CG=7005769410en_US
dc.identifier.scopusauthoridScatton, O=6603377848en_US
dc.identifier.scopusauthoridLaurent, A=7101728916en_US
dc.identifier.scopusauthoridAbdalla, EK=7006112354en_US
dc.identifier.scopusauthoridChaudhury, P=7004272033en_US
dc.identifier.scopusauthoridDutson, E=8210979200en_US
dc.identifier.scopusauthoridGamblin, C=25927124400en_US
dc.identifier.scopusauthoridD'Angelica, M=6701537742en_US
dc.identifier.scopusauthoridNagorney, D=35400419300en_US
dc.identifier.scopusauthoridTesta, G=7103337846en_US
dc.identifier.scopusauthoridLabow, D=6602481468en_US
dc.identifier.scopusauthoridManas, D=7003617874en_US
dc.identifier.scopusauthoridPoon, RT=7103097223en_US
dc.identifier.scopusauthoridNelson, H=7402584251en_US
dc.identifier.scopusauthoridMartin, R=35477245000en_US
dc.identifier.scopusauthoridClary, B=7003521582en_US
dc.identifier.scopusauthoridPinson, WC=20735007800en_US
dc.identifier.scopusauthoridMartinie, J=23100502700en_US
dc.identifier.scopusauthoridVauthey, JN=35270590000en_US
dc.identifier.scopusauthoridGoldstein, R=7403010697en_US
dc.identifier.scopusauthoridRoayaie, S=6602559540en_US
dc.identifier.scopusauthoridBarlet, D=35202949800en_US
dc.identifier.scopusauthoridEspat, J=23970062100en_US
dc.identifier.scopusauthoridAbecassis, M=35421633100en_US
dc.identifier.scopusauthoridRees, M=7201512301en_US
dc.identifier.scopusauthoridFong, Y=36014058900en_US
dc.identifier.scopusauthoridMcMasters, KM=35396537500en_US
dc.identifier.scopusauthoridBroelsch, C=7102083371en_US
dc.identifier.scopusauthoridBusuttil, R=7101995142en_US
dc.identifier.scopusauthoridBelghiti, J=35403099400en_US
dc.identifier.scopusauthoridStrasberg, S=7101931401en_US
dc.identifier.scopusauthoridChari, RS=35427660700en_US
dc.identifier.issnl0003-4932-

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