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Laparoscopic liver resection: a systematic review

  • Topics
  • Current status and future of laparoscopic liver resection
  • Published:
Journal of Hepato-Biliary-Pancreatic Surgery

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.

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References

  1. Gagner M, Rheault M, Dubuc J. Laparoscopic partial hepatectomy for liver tumor. Surg Endosc. 1993;6:99.

    Google Scholar 

  2. Cherqui D. Laparoscopic liver resection. Br J Surg. 2003;90(6):644–6.

    Article  PubMed  CAS  Google Scholar 

  3. Cherqui D, Husson E, Hammoud R, et al. Laparoscopic liver resections: a feasibility study in 30 patients. Ann Surg. 2000;232(6):753–62.

    Article  PubMed  CAS  Google Scholar 

  4. Descottes B, Lachachi F, Sodji M, et al. Early experience with laparoscopic approach for solid liver tumors: initial 16 cases. Ann Surg. 2000;232(5):641–5.

    Article  PubMed  CAS  Google Scholar 

  5. Hamy A, Paineau J, Savigny JL, Visset J. Laparoscopic hepatic surgery. Report of a clinical series of 11 patients. Int Surg. 1998;83(1):33–5.

    PubMed  CAS  Google Scholar 

  6. Samama G, Chiche L, Bréfort JL, Le Roux Y. Laparoscopic anatomical hepatic resection. Report of four left lobectomies for solid tumors. Surg Endosc. 1998;12(1):76–8.

    Article  PubMed  CAS  Google Scholar 

  7. Gugenheim J, Mazza D, Katkhouda N, Goubaux B, Mouiel J. Laparoscopic resection of solid liver tumours. Br J Surg. 1996;83(3):334–5.

    Article  PubMed  CAS  Google Scholar 

  8. Farges O, Jagot P, Kirstetter P, Marty J, Belghiti J. Prospective assessment of the safety and benefit of laparoscopic liver resections. J Hepatobiliary Pancreat Surg. 2002;9(2):242–8.

    Article  PubMed  Google Scholar 

  9. Soubrane O, Cherqui D, Scatton O, et al. Laparoscopic left lateral sectionectomy in living donors: safety and reproducibility of the technique in a single center. Ann Surg. 2006;244(5):815–20.

    Article  PubMed  Google Scholar 

  10. Dulucq JL, Wintringer P, Stabilini C, Berticelli J, Mahajna A. Laparoscopic liver resections: a single center experience. Surg Endosc. 2005;19(7):886–91.

    Article  PubMed  CAS  Google Scholar 

  11. Dagher I, Proske JM, Carloni A, Richa H, Tranchart H, Franco D. Laparoscopic liver resection: results for 70 patients. Surg Endosc. 2007;21(4):619–24.

    Article  PubMed  CAS  Google Scholar 

  12. Vibert E, Perniceni T, Levard H, Denet C, Shahri NK, Gayet B. Laparoscopic liver resection. Br J Surg. 2006;93(1):67–72.

    Article  PubMed  CAS  Google Scholar 

  13. Huscher CG, Lirici MM, Chiodini S. Laparoscopic liver resections. Semin Laparosc Surg. 1998;5:204–10.

    PubMed  CAS  Google Scholar 

  14. Morino M, Morra I, Rosso E, Miglietta C, Garrone C. Laparoscopic vs open hepatic resection: a comparative study. Surg Endosc. 2003;17(12):1914–8.

    Article  PubMed  CAS  Google Scholar 

  15. Croce E, Olmi S, Bertolini A, Erba L, Magnone S. Laparoscopic liver resection with radiofrequency. Hepatogastroenterology. 2003;50(54):2088–92.

    PubMed  CAS  Google Scholar 

  16. Borzellino G, Ruzzenente A, Minicozzi AM, Giovinazzo F, Pedrazzani C, Guglielmi A. Laparoscopic hepatic resection. Surg Endosc. 2006;20(5):787–90.

    Article  PubMed  CAS  Google Scholar 

  17. Belli G, Fantini C, D’Agostino A, Belli A, Russolillo N. Laparoscopic liver resections for hepatocellular carcinoma (HCC) in cirrhotic patients. HPB. 2004;6(4):236–46.

    PubMed  Google Scholar 

  18. Piccolboni D, Ciccone F, Settembre A, Corcione F. Liver resection with intraoperative and laparoscopic ultrasound: report of 32 cases: ultrasonic shears device for liver parenchymal transection. Surg Endosc. 2008;22(6):1421–6.

    Article  PubMed  Google Scholar 

  19. Santambrogio R, Opocher E, Ceretti AP, et al. Impact of intraoperative ultrasonography in laparoscopic liver surgery. Surg Endosc. 2007;21(2):181–8.

    Article  PubMed  CAS  Google Scholar 

  20. Pulitanò C, Catena M, Arru M, et al. Laparoscopic liver resection without portal clamping: a prospective evaluation. Surg Endosc. 2008;22(10):2196–200.

    Article  PubMed  Google Scholar 

  21. Bachellier P, Ayav A, Pai M, et al. Laparoscopic liver resection assisted with radiofrequency. Am J Surg. 2007;193(4):427–30.

    Article  PubMed  Google Scholar 

  22. Abu Hilal M, McPhail MJ, Zeidan B, et al. Laparoscopic versus open left lateral hepatic sectionectomy: a comparative study. Eur J Surg Oncol. 2008;34(12):1285–8.

    PubMed  CAS  Google Scholar 

  23. Spencer L, Metcalfe MS, Strickland AD, Elsey EJ, Robertson GS, Lloyd DM. Lessons from laparoscopic liver surgery: a nine-year case series. HPB Surg. 2008;2008:458137.

    Article  PubMed  Google Scholar 

  24. Alkari B, Owera A, Ammori BJ. Laparoscopic liver resection: preliminary results from a UK centre. Surg Endosc. 2008;22(10):2201–7.

    Article  PubMed  CAS  Google Scholar 

  25. Polignano FM, Quyn AJ, de Figueiredo RS, Henderson NA, Kulli C, Tait IS. Laparoscopic versus open liver segmentectomy: prospective, case-matched, intention-to-treat analysis of clinical outcomes and cost effectiveness. Surg Endosc. 2008;22(12):2564–70.

    Article  PubMed  Google Scholar 

  26. Troisi R, Montalti R, Smeets P, et al. The value of laparoscopic liver surgery for solid benign hepatic tumors. Surg Endosc. 2008;22(1):38–44.

    Article  PubMed  Google Scholar 

  27. Topal B, Fieuws S, Aerts R, Vandeweyer H, Penninckx F. Laparoscopic versus open liver resection of hepatic neoplasms: comparative analysis of short-term results. Surg Endosc. 2008;22(10):2208–13.

    Article  PubMed  CAS  Google Scholar 

  28. Rau HG, Buttler E, Meyer G, Schardey HM, Schildberg FW. Laparoscopic liver resection compared with conventional partial hepatectomy—a prospective analysis. Hepatogastroenterology. 1998;45(24):2333–8.

    PubMed  CAS  Google Scholar 

  29. Mala T, Edwin B, Gladhaug I, et al. A comparative study of the short-term outcome following open and laparoscopic liver resection of colorectal metastases. Surg Endosc. 2002;16(7):1059–63.

    Article  PubMed  CAS  Google Scholar 

  30. Robles R, Marín C, Abellán B, López A, Pastor P, Parrilla P. A new approach to hand-assisted laparoscopic liver surgery. Surg Endosc. 2008;22(11):2357–64.

    Article  PubMed  Google Scholar 

  31. Popescu I, Tomulescu V, Hrehoret D, Boeti-Sarbu P, Stanciulea O, Kosa A. Laparoscopic liver surgery. Analysis of a series of 61 patients. Rom J Gastroenterol. 2005;14(4):343–9.

    PubMed  Google Scholar 

  32. Berends FJ, Meijer S, Prevoo W, Bonjer HJ, Cuesta MA. Technical considerations in laparoscopic liver surgery. Surg Endosc. 2001;15(8):794–8.

    Article  PubMed  CAS  Google Scholar 

  33. Kánya L, Botos A, Bezsilla J, Szederkényi I, Tóth D. Laparoscopic surgery of focal lesions of the liver. Acta Chir Hung. 1999;38(2):187–9.

    PubMed  Google Scholar 

  34. Descottes B, Glineur D, Lachachi F, et al. Laparoscopic liver resection of benign liver tumors. Surg Endosc. 2003;17(1):23–30.

    Article  PubMed  CAS  Google Scholar 

  35. Mala T, Edwin B, Rosseland AR, Gladhaug I, Fosse E, Mathisen O. Laparoscopic liver resection: experience of 53 procedures at a single center. J Hepatobiliary Pancreat Surg. 2005;12(4):298–303.

    Article  PubMed  Google Scholar 

  36. Kaneko H. Laparoscopic hepatectomy: indications and outcomes. J Hepatobiliary Pancreat Surg. 2005;12(6):438–43.

    Article  PubMed  Google Scholar 

  37. Cai XJ, Yu H, Liang X, et al. Laparoscopic hepatectomy by curettage and aspiration. Experiences of 62 cases. Surg Endosc. 2006;20(10):1531–5.

    Article  PubMed  CAS  Google Scholar 

  38. Koffron AJ, Auffenberg G, Kung R, Abecassis M. Evaluation of 300 minimally invasive liver resections at a single institution: less is more. Ann Surg. 2007;246(3):385–92.

    Article  PubMed  Google Scholar 

  39. Chen HY, Juan CC, Ker CG. Laparoscopic liver surgery for patients with hepatocellular carcinoma. Ann Surg Oncol. 2008;15(3):800–6.

    Article  PubMed  Google Scholar 

  40. Buell JF, Thomas MT, Rudich S, et al. Experience with more than 500 minimally invasive hepatic procedures. Ann Surg. 2008;248(3):475–86.

    PubMed  Google Scholar 

  41. Cho JY, Han HS, Yoon YS, Shin SH. Experiences of laparoscopic liver resection including lesions in the posterosuperior segments of the liver. Surg Endosc. 2008;22(11):2344–9.

    Article  PubMed  Google Scholar 

  42. Bryant R, Laurent A, Tayar C, Cherqui D. Laparoscopic liver resection—understanding its role in current practice. The Henri Mondor Hospital experience. 2009 (in press).

  43. Sasaki A, Nitta H, Otsuka K, Takahara, T, Fujita T, Wakabayashi G. Total endoscopic liver resections: single institution’s 10-year experience. 2009 (in press).

  44. Ardito F, Tayar C, Laurent A, Karoui M, Loriau J, Cherqui D. Laparoscopic liver resection for benign disease. Arch Surg. 2007;142(12):1188–93.

    Article  PubMed  Google Scholar 

  45. Cai XJ, Yang J, Yu H, et al. Clinical study of laparoscopic versus open hepatectomy for malignant liver tumors. Surg Endosc. 2008;22(11):2350–6.

    Article  PubMed  Google Scholar 

  46. O’Rourke N, Shaw I, Nathanson L, Martin I, Fielding G. Laparoscopic resection of hepatic colorectal metastases. HPB. 2004;6(4):230–5.

    PubMed  Google Scholar 

  47. Fong Y, Brennan MF, Turnbull A, et al. Gallbladder cancer discovered during laparoscopic surgery—potential for iatrogenic dissemination. Arch Surg. 1993;128:1054–6.

    PubMed  CAS  Google Scholar 

  48. Johnstone PA, Rohde DC, Swartz SE, Fetter JE, Wexner SD. Port site recurrences after laparoscopic and thoracoscopic procedures in malignancy. J Clin Oncol. 1996;14(6):1950–6.

    PubMed  CAS  Google Scholar 

  49. Viganò L, Cherqui D. Laparoscopic liver resection in “Malignant liver tumors. Current and emerging therapies”, 3rd edn. Oxford: Blackwell; 2008.

  50. Belli G, Fantini C, D’Agostino A, et al. Laparoscopic versus open liver resection for hepatocellular carcinoma in patients with histologically proven cirrhosis: short- and middle-term results. Surg Endosc. 2007;21(11):2004–11.

    Article  PubMed  CAS  Google Scholar 

  51. Laurent A, Cherqui D, Lesurtel M, Brunetti F, Tayar C, Fagniez PL. Laparoscopic liver resection for subcapsular hepatocellular carcinoma complicating chronic liver disease. Arch Surg. 2003;138(7):763–9.

    Article  PubMed  Google Scholar 

  52. Cherqui D, Laurent A, Tayar C, et al. Laparoscopic liver resection for peripheral hepatocellular carcinoma in patients with chronic liver disease: midterm results and perspectives. Ann Surg. 2006;243(4):499–506.

    Article  PubMed  Google Scholar 

  53. Shimada M, Hashizume M, Maehara S, et al. Laparoscopic hepatectomy for hepatocellular carcinoma. Surg Endosc. 2001;15(6):541–4.

    Article  PubMed  CAS  Google Scholar 

  54. Kaneko H, Takagi S, Otsuka Y, et al. Laparoscopic liver resection of hepatocellular carcinoma. Am J Surg. 2005;189(2):190–4.

    Article  PubMed  Google Scholar 

  55. Dagher I, Lainas P, Carloni A, et al. Laparoscopic liver resection for hepatocellular carcinoma. Surg Endosc. 2008;22(2):372–8.

    Article  PubMed  Google Scholar 

  56. Teramoto K, Kawamura T, Takamatsu S, et al. Laparoscopic and thoracoscopic approaches for the treatment of hepatocellular carcinoma. Am J Surg. 2005;189(4):474–8.

    Article  PubMed  Google Scholar 

  57. Santambrogio R, Aldrighetti L, Barabino M, et al. Laparoscopic liver resections for hepatocellular carcinoma. Is it a feasible option for patients with liver cirrhosis? Langenbecks Arch Surg. 2009;394(2):255–64.

    Article  PubMed  CAS  Google Scholar 

  58. Huang MT, Lee WJ, Wang W, Wei PL, Chen RJ. Hand-assisted laparoscopic hepatectomy for solid tumor in the posterior portion of the right lobe: initial experience. Ann Surg. 2003;238(5):674–9.

    Article  PubMed  Google Scholar 

  59. Cho JY, Han HS, Yoon YS, Shin SH. Feasibility of laparoscopic liver resection for tumors located in the posterosuperior segments of the liver, with a special reference to overcoming current limitations on tumor location. Surgery. 2008;144(1):32–8.

    Article  PubMed  Google Scholar 

  60. Schmandra TC, Mierdl S, Bauer H, Gutt C, Hanisch E. Transoesophageal echocardiography shows high risk of gas embolism during laparoscopic hepatic resection under carbon dioxide pneumoperitoneum. Br J Surg. 2002;89(7):870–6.

    Article  PubMed  CAS  Google Scholar 

  61. Watanabe Y, Sato M, Ueda S, et al. Laparoscopic hepatic resection: a new and safe procedure by abdominal wall lifting method. Hepatogastroenterology. 1997;44(13):143–7.

    PubMed  CAS  Google Scholar 

  62. Biertho L, Waage A, Gagner M. Laparoscopic hepatectomy. Ann Chir. 2002;127(3):164–70.

    Article  PubMed  CAS  Google Scholar 

  63. Tang CN, Tsui KK, Ha JP, Yang GP, Li MK. A single-centre experience of 40 laparoscopic liver resections. Hong Kong Med J. 2006;12(6):419–25.

    PubMed  CAS  Google Scholar 

  64. Bazin JE, Gillart T, Rasson P, Conio N, Aigouy L, Schoeffler P. Haemodynamic conditions enhancing gas embolism after venous injury during laparoscopy: a study in pigs. Br J Anaesth. 1997;78(5):570–5.

    PubMed  CAS  Google Scholar 

  65. Palmer M, Miller CW, van Way CW 3rd, Orton EC. Venous gas embolism associated with argon-enhanced coagulation of the liver. J Invest Surg. 1993;6(5):391–9.

    Article  PubMed  CAS  Google Scholar 

  66. Simillis C, Constantinides VA, Tekkis PP, et al. Laparoscopic versus open hepatic resections for benign and malignant neoplasms—a meta-analysis. Surgery. 2007;141(2):203–11.

    Article  PubMed  Google Scholar 

  67. Chang S, Laurent A, Tayar C, Karoui M, Cherqui D. Laparoscopy as a routine approach for left lateral sectionectomy. Br J Surg. 2007;94(1):58–63.

    Article  PubMed  CAS  Google Scholar 

  68. Fong Y, Jarnagin W, Conlon KC, DeMatteo R, Dougherty E, Blumgart LH. Hand-assisted laparoscopic liver resection: lessons from an initial experience. Arch Surg. 2000;135:854–9.

    Article  PubMed  CAS  Google Scholar 

  69. Gayet B, Cavaliere D, Vibert E, et al. Totally laparoscopic right hepatectomy. Am J Surg. 2007;194(5):685–9.

    Article  PubMed  Google Scholar 

  70. O’Rourke N, Fielding G. Laparoscopic right hepatectomy: surgical technique. J Gastrointest Surg. 2004;8(2):213–6.

    Article  PubMed  Google Scholar 

  71. Dagher I, Caillard C, Proske JM, Carloni A, Lainas P, Franco D. Laparoscopic right hepatectomy: original technique and results. J Am Coll Surg. 2008;206(4):756–60.

    PubMed  Google Scholar 

  72. Koffron AJ, Kung RD, Auffenberg GB, Abecassis MM. Laparoscopic liver surgery for everyone: the hybrid method. Surgery. 2007;142:463–8.

    Article  PubMed  Google Scholar 

  73. Min SK, Han HS, Kim SW, Park YH, Lee HK, Lee JH. Initial experiences with laparoscopy-assisted and total laparoscopy for anatomical liver resection: a preliminary study. J Korean Med Sci. 2006;21:69–74.

    Article  PubMed  Google Scholar 

  74. Koffron AJ, Kung RD, Baker T, Fryer J, Clark L, Abecassis MM. Laparoscopic-assisted right lobe donor hepatectomy. Am J Transplant. 2006;6:2522–5.

    Article  PubMed  CAS  Google Scholar 

  75. Lesurtel M, Cherqui D, Laurent A, Tayar C, Fagniez PL. Laparoscopic versus open left lateral hepatic lobectomy: a case-control study. J Am Coll Surg. 2003;196(2):236–42.

    Article  PubMed  Google Scholar 

  76. Aldrighetti L, Pulitane C, Catena M, et al. A prospective evaluation of laparoscopic versus open left lateral hepatic sectionectomy. J Gastrointest Surg. 2008;12(3):457–62.

    Article  PubMed  Google Scholar 

  77. Lee KF, Cheung YS, Chong CN, et al. Laparoscopic versus open hepatectomy for liver tumours: a case control study. Hong Kong Med J. 2007;13(6):442–8.

    PubMed  CAS  Google Scholar 

  78. Buell JF, Thomas MJ, Doty TC, et al. An initial experience and evolution of laparoscopic hepatic resectional surgery. Surgery. 2004;136(4):804–11.

    Article  PubMed  Google Scholar 

  79. Cai X, Wang Y, Yu H, Liang X, Peng S. Laparoscopic hepatectomy for hepatolithiasis: a feasibility and safety study in 29 patients. Surg Endosc. 2007;21(7):1074–8.

    Article  PubMed  Google Scholar 

  80. Belghiti J, Hiramatsu K, Benoist S, Massault P, Sauvanet A, Farges O. Seven hundred forty-seven hepatectomies in the 1990s: an update to evaluate the actual risk of liver resection. J Am Coll Surg. 2000;191(1):38.

    Article  PubMed  CAS  Google Scholar 

  81. Lai EC, Fan ST, Lo CM, Chu KM, Liu CL, Wong J. Hepatic resection for hepatocellular carcinoma. An audit of 343 patients. Ann Surg. 1995;221(3):291–8.

    Article  PubMed  CAS  Google Scholar 

  82. Abdel-Atty MY, Farges O, Jagot P, Belghiti J. Laparoscopy extends the indications for liver resection in patients with cirrhosis. Br J Surg. 1999;86(11):1397–400.

    Article  PubMed  CAS  Google Scholar 

  83. Belli G, Fantini C, D’Agostino A, Belli A, Cioffi L, Russolillo N. Laparoscopic left lateral hepatic lobectomy: a safer and faster technique. J Hepatobiliary Pancreat Surg. 2006;13(2):149–54.

    Article  PubMed  Google Scholar 

  84. Cherqui D, Soubrane O, Husson E, et al. Laparoscopic living donor hepatectomy for liver transplantation in children. Lancet. 2002;359(9304):392–6.

    Article  PubMed  Google Scholar 

  85. Gigot JF, Glineur D, Santiago Azagra J, et al. Laparoscopic liver resection for malignant liver tumors: preliminary results of a multicenter European study. Ann Surg. 2002;236(1):90–7.

    Article  PubMed  Google Scholar 

  86. Jaeck D, Bachellier P, Oussoultzoglou E, Weber JC, Wolf P. Surgical resection of hepatocellular carcinoma. Post-operative outcome and long-term results in Europe: an overview. Liver Transpl. 2004;10[Suppl 1]:S58–63.

    Article  PubMed  Google Scholar 

  87. Fong Y, Sun RL, Jarnagin W, Blumgart LH. An analysis of 412 cases of hepatocellular carcinoma at a Western center. Ann Surg. 1999;229(6):790–9.

    Article  PubMed  CAS  Google Scholar 

  88. Poon RT, Fan ST, Lo CM, et al. Improving survival results after resection of hepatocellular carcinoma: a prospective study of 377 patients over 10 years. Ann Surg. 2001;234(1):63–70.

    Article  PubMed  CAS  Google Scholar 

  89. Adam R, Azoulay D, Castaing D, et al. Liver resection as a bridge to transplantation for hepatocellular carcinoma on cirrhosis: a reasonable strategy? Ann Surg. 2003;238(4):508–18.

    PubMed  Google Scholar 

  90. Laurent A, Tayar C, Andréoletti M, Lauzet JY, Merle JC, Cherqui D. Laparoscopic liver resection facilitates salvage liver transplantation for hepatocellular carcinoma. J Hepatobiliary Pancreat Surg. Epub 12 Mar 2009.

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Correspondence to Daniel Cherqui.

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Viganò, L., Tayar, C., Laurent, A. et al. Laparoscopic liver resection: a systematic review. J Hepatobiliary Pancreat Surg 16, 410–421 (2009). https://doi.org/10.1007/s00534-009-0120-8

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