TY - JOUR
T1 - Approaches to laparoscopic liver resection
T2 - A meta-analysis of the role of hand-assisted laparoscopic surgery and the hybrid technique
AU - Hasegawa, Yasushi
AU - Koffron, Alan J.
AU - Buell, Joseph F.
AU - Wakabayashi, Go
N1 - Publisher Copyright:
© 2015 Japanese Society of Hepato-Biliary-Pancreatic Surgery.
PY - 2015/5/1
Y1 - 2015/5/1
N2 - Abstract Laparoscopic liver resection has been established as a safe and feasible treatment option. Surgical approaches include pure laparoscopy, hand-assisted laparoscopy (HALS), and the hybrid technique. The role of these three approaches, and their superiority over open laparotomy, is not yet known. A literature review was performed using specific search phrases, relating to hand-assisted or hybrid approaches to laparoscopic liver resection. Surgical results from 18 case series (HALS, nine series; hybrid technique, nine series), each with ≥10 patients, were analyzed. Results indicated that HALS was associated with a mean operative time of 82-264.5min, an estimated blood loss of 82-300mL, and a complication rate of 3.8-27.1%. Analysis of series involving the hybrid technique indicated a mean operative time of 111-366.5 min, an estimated blood loss of 93-936 mL, and a complication rate of 3.4-23.5%. In conclusion, there is insufficient evidence to conclude that any single approach is superior to the others, although HALS and the hybrid technique are useful when dealing with difficulties associated with pure laparoscopy. Conversely, the need for these two methods, which can function as a bridge to pure laparoscopic liver resection, may be overcome with appropriate training.
AB - Abstract Laparoscopic liver resection has been established as a safe and feasible treatment option. Surgical approaches include pure laparoscopy, hand-assisted laparoscopy (HALS), and the hybrid technique. The role of these three approaches, and their superiority over open laparotomy, is not yet known. A literature review was performed using specific search phrases, relating to hand-assisted or hybrid approaches to laparoscopic liver resection. Surgical results from 18 case series (HALS, nine series; hybrid technique, nine series), each with ≥10 patients, were analyzed. Results indicated that HALS was associated with a mean operative time of 82-264.5min, an estimated blood loss of 82-300mL, and a complication rate of 3.8-27.1%. Analysis of series involving the hybrid technique indicated a mean operative time of 111-366.5 min, an estimated blood loss of 93-936 mL, and a complication rate of 3.4-23.5%. In conclusion, there is insufficient evidence to conclude that any single approach is superior to the others, although HALS and the hybrid technique are useful when dealing with difficulties associated with pure laparoscopy. Conversely, the need for these two methods, which can function as a bridge to pure laparoscopic liver resection, may be overcome with appropriate training.
KW - Hand-assisted
KW - Hepatectomy
KW - Hybrid
KW - Laparoscopic liver resection
KW - Laparoscopy-assisted
UR - http://www.scopus.com/inward/record.url?scp=84928315483&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84928315483&partnerID=8YFLogxK
U2 - 10.1002/jhbp.214
DO - 10.1002/jhbp.214
M3 - Article
C2 - 25612233
AN - SCOPUS:84928315483
VL - 22
SP - 335
EP - 341
JO - Journal of Hepato-Biliary-Pancreatic Sciences
JF - Journal of Hepato-Biliary-Pancreatic Sciences
SN - 1868-6974
IS - 5
ER -