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Erschienen in: Surgical Endoscopy 3/2017

05.08.2016

Clinical impact of laparoscopic hepatectomy: technical and oncological viewpoints

verfasst von: Shohei Komatsu, Raffaele Brustia, Claire Goumard, Ailton Sepulveda, Fabiano Perdigao, Olivier Soubrane, Olivier Scatton

Erschienen in: Surgical Endoscopy | Ausgabe 3/2017

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Abstract

The objective of this study was to assess the clinical impact of laparoscopic hepatectomy from technical and oncological viewpoints through the consecutive 5-year experience of an expert team. The subjects consisted of 491 consecutive hepatectomies performed over the course of 5 years. A total of 190 hepatectomies (38.6 %) were performed laparoscopically, and the remaining 301 (61.4 %) were open hepatectomies. Chronological trends of operative procedures and their indications were evaluated, and patients with hepatocellular carcinoma (HCC) were analyzed from an oncological viewpoint. The proportion of laparoscopic hepatectomies performed increased significantly during the study period (from 17.6 to 49.5 %). According to chronological trends, right hepatectomy was standardized using consecutive steps after minor hepatectomy, left lateral sectionectomy, and left hepatectomy were standardized. The proportion of laparoscopic hepatectomies performed for HCC increased from 21.4 to 71.0 %. No significant difference was observed in the proportion of major hepatectomies performed for HCC between the open and laparoscopy groups (50.6 vs. 48.6 %, p = 0.8053), whereas that of anatomical segmentectomy for HCC was significantly lower in the laparoscopy group (28.7 vs. 11.1 %, p = 0.0064). All laparoscopic anatomical segmentectomies were of segments 5 and 6, and there was no segmentectomy of posterosuperior lesions. The present study shows the consecutive technical developmental processes for minor hepatectomy, left lateral sectionectomy, left hepatectomy, and right hepatectomy without compromising oncological principles. Laparoscopic anatomical segmentectomy for posterosuperior lesions may be the most technically demanding procedure, requiring individualized standardization.
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Metadaten
Titel
Clinical impact of laparoscopic hepatectomy: technical and oncological viewpoints
verfasst von
Shohei Komatsu
Raffaele Brustia
Claire Goumard
Ailton Sepulveda
Fabiano Perdigao
Olivier Soubrane
Olivier Scatton
Publikationsdatum
05.08.2016
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 3/2017
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-016-5135-z

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