Expert consensus on laparoscopic hepatectomy (2013 Version)

Abstract

Background

Laparoscopic hepatectomy has many advantages over open surgery, including minimization of local injury, reduced systemic reactions, and faster postoperative recovery. The aim of this “Consensus” is to provide guidance and reference to surgeons who perform, or are interested in performing laparoscopic liver surgeries.

Methods

The National Hepatic Surgery Group of the Society of Surgery, a professional society of the Chinese Medical Association, gathered 60 expert hepatic surgeons in Wuhan, China in December 2012, and an “Expert Consensus on Laparoscopic Hepatectomy” was developed.

Results

The types of hepatectomy, indications and contraindications, preoperative preparation, anesthesia, patient position, insufflation pressure, port position, control of hepatic inflow and outflow, indications for conversion to open surgery, and surgical devices and equipment are reviewed. Techniques and procedures of various laparoscopic hepatectomies are also discussed.

References

[1] ReichH, McGlynnF, DeCaprioJ, et al.. Laparoscopic excision of benign liver lesions. Obstet Gynecol, 1991, 78(5Pt2): 956-958

[2] BryantR, LaurentA, TayarC, et al.. Laparoscopic liver resection—understanding its role in current practice. Ann Surg, 2009, 250(1): 103-111

[3] IshizawaT, GumbsAA, KokudoN, et al.. Laparoscopic segmentectomy of the liver (From segment I to VIII). Ann Surg, 2012, 256(6): 959-964

[4] NguyenKT, GamblinTC, GellerDA. World review of laparoscopic liver resection—2804 patients. Ann Surg, 2009, 250(5): 831-841

[5] CherquiD, SoubraneO, HussonE, et al.. Laparoscopic living donor hepatectomy for liver transplantation in children. Lancet, 2002, 359(9304): 368-370

[6] XiaoZY, ChenXP, HuangZY, et al.. 20 Case reports of laparascopic hepatectomy applying a new kind of microwave dissector. Zhongguo Weichuang Waike Zazhi (Chinese), 2005, 5(11): 880-881

[7] LiuR, HuangZQ, ZhouNX, et al.. Operational line of laparoscopic liver resections. Natl Med J China (Chinese), 2004, 84(3): 219-221

[8] CaiXJ, WangXF, LiLB, et al.. The use of liver transaction by curettage and aspiration in laparoscopic hepatectomy. Zhonghua Waike Zazhi (Chinese), 2001, 39(3): 202-204

[9] ZhouWP, SunZH, WuMC, et al.. The resection of hepatic tumors in laparoscopic hepatectomy. Gan Dan Yi Waike Zazhi (Chinese), 1994, 6(1): 3-5

[10] LiCL, ZouYT, YuXY, et al.. The resection of hepatic tumors by laparoscopic technique. Xiandai Linchuang Putong Waike (Chinese), 1996, 1(1): 29

[11] National laparoscopicendoscopic surgery group.. Chinese Society of Surgery, Chinese Medical Association. Guide to laparoscopic hepatectomy operations. Zhongguo Shiyong Waike Zazhi (Chinese), 2010, 30(8): 669-671

[12] BuellJF, CherquiD, GellerDA, et al.. The international position on laparoscopic liver surgery (The Louisville Statement, 2008). Ann Surg, 2009, 250(5): 825-830

[13] XuJ, WuY, DongF. Clinical value of contrast-enhanced ultrasound in differentiating benign and malignant focal liver lesions. J Huazhong Univ Sci Technol Med Sci, 2007, 27(6): 703-705

[14] HuangZY, ChenG, HaoXY, et al.. Outcomes of non-anatomic liver resection for hepatocellular carcinoma in the patients with liver cirrhosis and analysis of prognostic factors. Langenbecks Arch Surg, 2011, 396(2): 193-199

[15] ChenXP, ZhangZW, ZhangBX, et al.. Modified technique of hepatic vascular exclusion: effect on blood loss during complex mesohepatectomy in hepatocellular carcinoma patients with cirrhosis. Langenbecks Arch Surg, 2006, 391(3): 209-215

[16] ChenXP, QiuFZ. A Simple technique ligating the corresponding inflow and outflow vessels during anatomical hepatectomy. Langenbecks Arch Surg, 2007, 393(2): 227-230

[17] ChenXP, ZhangZW, HuangZY, et al.. Alternative management of anatomical right hemihepatectomy using ligation of inflow and outflow vessels without hilus dissection. J Gastroenterol Hepatol, 2011, 26(4): 663-668