-Review-

Current Status of Laparoscopic Hepatectomy

Hiroshi Yoshida, Nobuhiko Taniai, Masato Yoshioka, Atsushi Hirakata, Youichi Kawano, Tetsuya Shimizu, Junji Ueda, Hideyuki Takata, Yoshiharu Nakamura and Yasuhiro Mamada

Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan

Before the first laparoscopic hepatectomy (LH) was described in 1991, open hepatectomy (OH) was the only choice for surgical treatment of liver tumors. LH indications were initially based solely on tumor location, size, and type. Use of LH has spread rapidly worldwide because it reduces incision size. This review systematically assesses the current status of LH. As compared with OH, LH is significantly less complicated, requires shorter hospital stays, and results in less blood loss. The long-term survival rates of LH and OH are comparable. Development of new techniques and instruments will improve the conversion rate and reduce complications. Furthermore, development of surgical navigation will improve LH safety and efficacy. Laparoscopic major hepatectomy for HCC remains a challenging procedure and should only be performed by experienced surgeons. In the near future, a training system for young surgeons will become mandatory for standardization of LH, and LH will likely become better standardized and have broader applications.

J Nippon Med Sch 2019; 86: 201-206

Keywords
laparoscopy, liver resection, hepatectomy, hepatocellular carcinoma (HCC)

Correspondence to
Hiroshi Yoshida, MD, Department of GI and HBP Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
hiroshiy@nms.ac.jp

Received, March 6, 2019
Accepted, May 22, 2019