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The current role of laparoscopic liver resection for the treatment of liver tumors

Nature Clinical Practice Gastroenterology & Hepatology volume 5, pages 648–654 (2008)Cite this article

Abstract

Laparoscopic liver resection (LLR) represents a natural extension of minimally invasive surgery. Several case–control studies have demonstrated that LLR is safe and feasible in carefully selected patients. LLR is associated with reduced operative blood loss and earlier recovery when compared with open surgery. In addition, oncologic clearance achieved with LLR is comparable to that achieved with open surgery. Improved cosmesis and postoperative patient comfort also argue in favor of LLR compared with open surgery. When considering whether a patient is suitable for LLR, the size and location of the neoplasm must be taken into account. Operator experience must also be considered as LLR is technically demanding and requires experience in conventional hepatobiliary surgery and advanced laparoscopy. The main indication for LLR is limited resection of superficial or peripherally located tumors. In the case of malignant tumors, LLR should be indicated only if a safe and effective oncologic resection can be performed, and the availability of laparoscopy should not change the indications for benign lesions. Ultimately, the future application of LLR will depend on how easily liver surgeons can master the technique and whether the long-term results of LLR can match those achieved with open resection.

Key Points

  • Laparoscopic liver resection is safe and feasible in selected patients

  • Laparoscopic procedures should only be used when an open procedure is clearly indicated

  • Laparoscopic liver resection is predominantly performed in patients with peripherally located benign or malignant liver lesions, although the use of the laparoscopic approach for major liver resection has been reported

  • Studies in patients with cirrhosis have suggested that the laparoscopic approach might reduce the incidence of postoperative complications

  • Widespread application of minimally invasive surgery for hepatic resection will depend on how easily it can be mastered by liver surgeons and whether long-term outcomes similar to those associated with open resection can be achieved while retaining the benefit of laparoscopy

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Figure 1: Transection of liver parenchyma.

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Authors and Affiliations

  1. C Pulitanò is a Resident in General Surgery and L Aldrighetti is Chief of the Liver Unit in the Department of Surgery, Scientific Institute San Raffaele, Vita-Salute San Raffaele University, Milan, Italy.,

    Carlo Pulitanò & Luca Aldrighetti

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  1. Carlo Pulitanò
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  2. Luca Aldrighetti
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Correspondence to Luca Aldrighetti.

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The authors declare no competing financial interests.

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Pulitanò, C., Aldrighetti, L. The current role of laparoscopic liver resection for the treatment of liver tumors. Nat Rev Gastroenterol Hepatol 5, 648–654 (2008). https://doi.org/10.1038/ncpgasthep1253

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