Systematic review of the feasibility and future of laparoscopic liver resection for difficult lesions.

Abstract:

:Laparoscopic liver resection (LLR) is now performed widely, but is difficult to accomplish in some anatomical locations, such as the posterosuperior segments (S7 and S8) and caudate lobe (S1). An international survey revealed that lesions in these locations are less frequently indicated for LLR than those in other segments. Recent reports from experienced centers document several case series and present technical tips for treating such lesions. The lateral approach using intercostal (transdiaphragmatic) trocars was reported to be useful for lesions in the posterosuperior segments with a semi- to full-decubitus position. The thoracoscopic approach was also reported to be useful for lesions just under the diaphragm dome, but the tumor location and patient selection should be considered carefully because pneumoperitoneum pressure and Pringle's maneuver cannot be applied. Several case series have described the feasibility of LLR for caudate lobe lesions, with similar operative outcomes to lesions in the posterosuperior segments, but this demands technical expertise. The caudal view of laparoscopy is advantageous for approaching the caudate lobe. We conducted a systematic review to clarify the feasibility of LLR for difficult lesions and discuss its current and future status.

journal_name

Surg Today

journal_title

Surgery today

authors

Araki K,Kubo N,Watanabe A,Kuwano H,Shirabe K

doi

10.1007/s00595-017-1607-6

subject

Has Abstract

pub_date

2018-07-01 00:00:00

pages

659-666

issue

7

eissn

0941-1291

issn

1436-2813

pii

10.1007/s00595-017-1607-6

journal_volume

48

pub_type

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