Pagina Iniziale » Fegato » Linee Guida Resezioni Epatiche Laparoscopiche
Principali Linee Guida per le Resezioni Epatiche Laparoscopiche
In questa pagina sono raccolte e (tentativamente) sempre aggiornate le principali linee guida nazionali ed internazionali sulle indicazioni e le modalità di esecuzione delle Resezioni Epatiche Laparoscopiche.
Molte di queste Linee Guida hanno una importante implicazione per il trattamento chirurgico.
La consultazione di qualcuna fra le linea guida qui elencate potrebbe non essere offerta in maniera gratuita dal sito dell’editore del giornale scientifico che l’ha pubblicata.
Seleziona, aprendo il menù, la categoria di Linee Guida che vuoi vedere:
- Epatocarcinoma
- Colangiocarcinoma
- Metastasi
- Tumori Benigni Fegato
- Chirurgia Epatica
- Resezioni Laparo
- Resezioni Robotiche
- Trapianto Fegato
- ERAS Chirurgia Fegato
- Tumore Colecisti
- Calcoli Colecisti
- Polipi Colecisti
- Colangite Acuta
- Danni Via Biliare
- Tumore del Pancreas
- IPMN – Tumori Cistici Pancreas
- Pancreatite Acuta
- Chirurgia Pancreas
- ERAS Pancreas
- Traumi Fegato
- Esami Fegato
- Diagnosi Lesioni Focali Epatiche
- Centro di Chirurgia HBP
- Storia Chirurgia Epatobiliare
- Tutte le Linee Guida
2022
Gotohda N; Cherqui D; Geller D A; Hilal M A; Berardi G; Ciria R; Abe Y; Aoki T; Asbun H; Chan A C Y; Chanwat R; Chen K; Chen Y; Cheung T T; Fuks D; Han H; Hasegawa K; Hatano E; Honda G; Itano O; Iwashita Y; Kaneko H; Kato Y; Kim J H; Liu R; López-Ben S; Morimoto M; Monden K; Rotellar F; Sakamoto Y; Sugioka A; Yoshiizumi T; Akahoshi K; Alconchel F; Ariizumi S; Cacciaguerra A B; Durán M; Vazquez A G; Golse N; Miyasaka Y; Mori Y; Ogiso S; Shirata C; Tomassini F; Urade T; Wakabayashi T; Nishino H; Hibi T; Kokudo N; Ohtsuka M; Ban D; Nagakawa Y; Ohtsuka T; Tanabe M; Nakamura M; Yamamoto M; Tsuchida A; Wakabayashi G
Expert Consensus Guidelines: How to safely perform minimally invasive anatomic liver resection Journal Article
In: Journal of Hepato-Biliary-Pancreatic Sciences, vol. 29, no. 1, pp. 16 – 32, 2022, ISSN: 18686974, (Cited by: 6).
@article{Gotohda202216,
title = {Expert Consensus Guidelines: How to safely perform minimally invasive anatomic liver resection},
author = {Naoto Gotohda and Daniel Cherqui and David A. Geller and Mohammed Abu Hilal and Giammauro Berardi and Ruben Ciria and Yuta Abe and Takeshi Aoki and Horacio J. Asbun and Albert C. Y. Chan and Rawisak Chanwat and Kuo-Hsin Chen and Yajin Chen and Tan To Cheung and David Fuks and Ho-Seong Han and Kiyoshi Hasegawa and Etsuro Hatano and Goro Honda and Osamu Itano and Yukio Iwashita and Hironori Kaneko and Yutaro Kato and Ji Hoon Kim and Rong Liu and Santiago López-Ben and Mamoru Morimoto and Kazuteru Monden and Fernando Rotellar and Yoshihiro Sakamoto and Atsushi Sugioka and Tomoharu Yoshiizumi and Keiichi Akahoshi and Felipe Alconchel and Shunichi Ariizumi and Andrea Benedetti Cacciaguerra and Manuel Durán and Alain Garcia Vazquez and Nicolas Golse and Yoshihiro Miyasaka and Yasuhisa Mori and Satoshi Ogiso and Chikara Shirata and Federico Tomassini and Takeshi Urade and Taiga Wakabayashi and Hitoe Nishino and Taizo Hibi and Norihiro Kokudo and Masayuki Ohtsuka and Daisuke Ban and Yuichi Nagakawa and Takao Ohtsuka and Minoru Tanabe and Masafumi Nakamura and Masakazu Yamamoto and Akihiko Tsuchida and Go Wakabayashi},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85120333965&doi=10.1002%2fjhbp.1079&partnerID=40&md5=0d8416f2da4ced3e0e385cddfa049f97},
doi = {10.1002/jhbp.1079},
issn = {18686974},
year = {2022},
date = {2022-01-01},
urldate = {2022-01-01},
journal = {Journal of Hepato-Biliary-Pancreatic Sciences},
volume = {29},
number = {1},
pages = {16 – 32},
publisher = {John Wiley and Sons Inc},
abstract = {Background: The concept of minimally invasive anatomic liver resection (MIALR) is gaining popularity. However, specific technical skills need to be acquired to safely perform MIALR. The “Expert Consensus Meeting: Precision Anatomy for Minimally Invasive HBP Surgery (PAM-HBP Surgery Consensus)” was developed as a special program during the 32nd meeting of the Japanese Society of Hepato-Biliary-Pancreatic Surgery (JSHBPS). Methods: Thirty-four international experts gathered online for the consensus. A Research Committee performed a comprehensive literature review, classifying studies according to the Scottish Intercollegiate Guidelines Network method. Based on the literature review and experts’ opinions, tentative recommendations were drafted and circulated among experts using online Delphi Rounds. Finally, formulated recommendations were presented online in the Expert Consensus Meeting of the JSHBPS on February 23rd, 2021. The final recommendations were validated and finalized by the 2nd Delphi Round in May 2021. Results: Seven clinical questions were selected, and 22 recommendations were formulated. All recommendations reached more than 85% consensus among experts at the final Delphi Round. Conclusions: The Expert Consensus Meeting for safely performing MIALR has presented a set of clinical guidelines based on available literature and experts’ opinions. We expect these guidelines to have a favorable effect on the safe implementation and development of MIALR. © 2021 Japanese Society of Hepato-Biliary-Pancreatic Surgery},
note = {Cited by: 6},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2021
Cherqui D; Ciria R; Kwon C H D; Kim K; Broering D; Wakabayashi G; Samstein B; Troisi R I; Han H S; Rotellar F; Soubrane O; Briceño J; Alconchel F; Ayllón M D; Berardi G; Cauchy F; Luque I G; Hong S K; Yoon Y; Egawa H; Lerut J; Lo C; Rela M; Sapisochin G; Suh K
In: Annals of Surgery, vol. 273, no. 1, pp. 96 – 108, 2021, ISSN: 00034932, (Cited by: 13).
@article{Cherqui202196,
title = {Expert consensus guidelines on minimally invasive donor hepatectomy for living donor liver transplantation from innovation to implementation: A joint initiative from the international laparoscopic liver society (ILLS) and the Asian-Pacific hepato-pancreato-biliary association (A-PHPBA)},
author = {Daniel Cherqui and Ruben Ciria and Choon Hyuck David Kwon and Ki-Hun Kim and Dieter Broering and Go Wakabayashi and Benjamin Samstein and Roberto I. Troisi and Ho Seong Han and Fernando Rotellar and Olivier Soubrane and Javier Briceño and Felipe Alconchel and María Dolores Ayllón and Giammauro Berardi and Francois Cauchy and Irene Gómez Luque and Suk Kyun Hong and Young-Yin Yoon and Hiroto Egawa and Jan Lerut and Chung-Mau Lo and Mohamed Rela and Gonzalo Sapisochin and Kyung-Suk Suh},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85098676552&doi=10.1097%2fSLA.0000000000004475&partnerID=40&md5=93cd12ffcabe36ce8cde34e0c0368823},
doi = {10.1097/SLA.0000000000004475},
issn = {00034932},
year = {2021},
date = {2021-01-01},
urldate = {2021-01-01},
journal = {Annals of Surgery},
volume = {273},
number = {1},
pages = {96 – 108},
publisher = {Lippincott Williams and Wilkins},
abstract = {Objective: The Expert Consensus Guidelines initiative on MIDH for LDLT was organized with the goal of safe implementation and development of these complex techniques with donor safety as the main priority. Background: Following the development of minimally invasive liver surgery, techniques of MIDH were developed with the aim of reducing the short- and long-term consequences of the procedure on liver donors. These techniques, although increasingly performed, lack clinical guidelines. Methods: A group of 12 international MIDH experts, 1 research coordinator, and 8 junior faculty was assembled. Comprehensive literature search was made and studies classified using the SIGN method. Based on literature review and experts opinions, tentative recommendations were made by experts subgroups and submitted to the whole experts group using on-line Delphi Rounds with the goal of obtaining >90% Consensus. Pre-conference meeting formulated final recommendations that were presented during the plenary conference held in Seoul on September 7, 2019 in front of a Validation Committee composed of LDLT experts not practicing MIDH and an international audience. Results: Eighteen Clinical Questions were addressed resulting in 44 recommendations. All recommendations reached at least a 90% consensus among experts and were afterward endorsed by the validation committee. Conclusions: The Expert Consensus on MIDH has produced a set of clinical guidelines based on available evidence and clinical expertise. These guidelines are presented for a safe implementation and development of MIDH in LDLT Centers with the goal of optimizing donor safety, donor care, and recipient outcomes. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.},
note = {Cited by: 13},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2018
Han H; Cho J Y; Kaneko H; Wakabayashi G; Okajima H; Uemoto S; Soubrane O; Yong C; Chen C; Cheung T T; Belli G; Kubo S; Wu Y; Chen K; Troisi R I; Kwon C H D; Suh K; Soin A S; Kim K; Cherqui D
Expert Panel Statement on Laparoscopic Living Donor Hepatectomy Journal Article
In: Digestive Surgery, vol. 35, no. 4, pp. 284 – 288, 2018, ISSN: 02534886, (Cited by: 37; All Open Access, Bronze Open Access).
@article{Han2018284,
title = {Expert Panel Statement on Laparoscopic Living Donor Hepatectomy},
author = {Ho-Seong Han and Jai Young Cho and Hironori Kaneko and Go Wakabayashi and Hideaki Okajima and Shinji Uemoto and Olivier Soubrane and Chee-Chien Yong and Chao-Long Chen and Tan To Cheung and Giulio Belli and Shoji Kubo and Yao-Ming Wu and Kuo-Hsin Chen and Roberto I. Troisi and Choon Hyuck David Kwon and Kyung-Suk Suh and Arvinder S. Soin and Ki-Hun Kim and Daniel Cherqui},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85031772566&doi=10.1159%2f000479242&partnerID=40&md5=127351114b501ad633d0b7031ab86108},
doi = {10.1159/000479242},
issn = {02534886},
year = {2018},
date = {2018-01-01},
urldate = {2018-01-01},
journal = {Digestive Surgery},
volume = {35},
number = {4},
pages = {284 – 288},
publisher = {S. Karger AG},
abstract = {Background: With improvements in living donor liver transplantation (LDLT) techniques and the increased experience of surgeons in laparoscopic major liver resection, laparoscopic donor hepatectomy is performed increasingly. Therefore, expert opinion on this procedure is required. Objective: The study aimed to report the current status and summarize the expert opinion on laparoscopic donor hepatectomy. Methods: An expert consensus meeting was held on September 8, 2016, in Seoul, Korea. Results: Laparoscopic donor left lateral sectionectomy could be considered the standard practice in pediatric LDLT. In adult LDLT, laparoscopy-assisted donor hepatectomy or left hepatectomy is potentially the next need, requiring more evidence for becoming standard practice. Laparoscopic donor right hepatectomy is still in the developmental stage, and more supporting evidence is required. Waving the cost consideration, the robotic approach could be a valid alternative for the suitable approaches of laparoscopy. Conclusions: Laparoscopic donor hepatectomy is increasing its role in both pediatric and adult LDLT. However, for major donor hepatectomy, more evidence is needed. © 2017 S. Karger AG, Basel.},
note = {Cited by: 37; All Open Access, Bronze Open Access},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Hilal M A; Aldrighetti L; Dagher I; Edwin B; Troisi R I; Alikhanov R; Aroori S; Belli G; Besselink M; Briceno J; Gayet B; D'Hondt M; Lesurtel M; Menon K; Lodge P; Rotellar F; Santoyo J; Scatton O; Soubrane O; Sutcliffe R; Dam R V; White S; Halls M C; Cipriani F; Poel M V D; Ciria R; Barkhatov L; Gomez-Luque Y; Ocana-Garcia S; Cook A; Buell J; Clavien P; Dervenis C; Fusai G; Geller D; Lang H; Primrose J; Taylor M; Gulik T V; Wakabayashi G; Asbun H; Cherqui D
The Southampton Consensus Guidelines for Laparoscopic Liver Surgery: From Indication to Implementation Journal Article
In: Annals of Surgery, vol. 268, no. 1, pp. 11 – 18, 2018, ISSN: 00034932, (Cited by: 300; All Open Access, Green Open Access).
@article{Hilal201811,
title = {The Southampton Consensus Guidelines for Laparoscopic Liver Surgery: From Indication to Implementation},
author = {Mohammad Abu Hilal and Luca Aldrighetti and Ibrahim Dagher and Bjorn Edwin and Roberto Ivan Troisi and Ruslan Alikhanov and Somaiah Aroori and Giulio Belli and Marc Besselink and Javier Briceno and Brice Gayet and Mathieu D'Hondt and Mickael Lesurtel and Krishna Menon and Peter Lodge and Fernando Rotellar and Julio Santoyo and Olivier Scatton and Olivier Soubrane and Robert Sutcliffe and Ronald Van Dam and Steve White and Mark Christopher Halls and Federica Cipriani and Marcel Van Der Poel and Ruben Ciria and Leonid Barkhatov and Yrene Gomez-Luque and Sira Ocana-Garcia and Andrew Cook and Joseph Buell and Pierre-Alain Clavien and Christos Dervenis and Giuseppe Fusai and David Geller and Hauke Lang and John Primrose and Mark Taylor and Thomas Van Gulik and Go Wakabayashi and Horacio Asbun and Daniel Cherqui},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85050192036&doi=10.1097%2fSLA.0000000000002524&partnerID=40&md5=bbabf9a6655466fb4d0d1ab48dea99a6},
doi = {10.1097/SLA.0000000000002524},
issn = {00034932},
year = {2018},
date = {2018-01-01},
urldate = {2018-01-01},
journal = {Annals of Surgery},
volume = {268},
number = {1},
pages = {11 – 18},
publisher = {Lippincott Williams and Wilkins},
abstract = {Objective: The European Guidelines Meeting on Laparoscopic Liver Surgery was held in Southampton on February 10 and 11, 2017 with the aim of presenting and validating clinical practice guidelines for laparoscopic liver surgery. Background: The exponential growth of laparoscopic liver surgery in recent years mandates the development of clinical practice guidelines to direct the speciality's continued safe progression and dissemination. Methods: A unique approach to the development of clinical guidelines was adopted. Three well-validated methods were integrated: the Scottish Intercollegiate Guidelines Network methodology for the assessment of evidence and development of guideline statements; the Delphi method of establishing expert consensus, and the AGREE II-GRS Instrument for the assessment of the methodological quality and external validation of the final statements. Results: Along with the committee chairman, 22 European experts; 7 junior experts and an independent validation committee of 11 international surgeons produced 67 guideline statements for the safe progression and dissemination of laparoscopic liver surgery. Each of the statements reached at least a 95% consensus among the experts and were endorsed by the independent validation committee. Conclusion: The European Guidelines Meeting for Laparoscopic Liver Surgery has produced a set of clinical practice guidelines that have been independently validated for the safe development and progression of laparoscopic liver surgery. The Southampton Guidelines have amalgamated the available evidence and a wealth of experts' knowledge taking in consideration the relevant stakeholders' opinions and complying with the international methodology standards. © 2017 Wolters Kluwer Health, Inc. All rights reserved.},
note = {Cited by: 300; All Open Access, Green Open Access},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Cho J Y; Han H; Wakabayashi G; Soubrane O; Geller D; O'Rourke N; Buell J; Cherqui D
Practical guidelines for performing laparoscopic liver resection based on the second international laparoscopic liver consensus conference Journal Article
In: Surgical Oncology, vol. 27, no. 1, pp. A5 – A9, 2018, ISSN: 09607404, (Cited by: 43; All Open Access, Hybrid Gold Open Access).
@article{Cho2018A5,
title = {Practical guidelines for performing laparoscopic liver resection based on the second international laparoscopic liver consensus conference},
author = {Jai Young Cho and Ho-Seong Han and Go Wakabayashi and Olivier Soubrane and David Geller and Nicholas O'Rourke and Joseph Buell and Daniel Cherqui},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85044851854&doi=10.1016%2fj.suronc.2017.12.003&partnerID=40&md5=fce5f9f32549843fbb11f0211caa976b},
doi = {10.1016/j.suronc.2017.12.003},
issn = {09607404},
year = {2018},
date = {2018-01-01},
urldate = {2018-01-01},
journal = {Surgical Oncology},
volume = {27},
number = {1},
pages = {A5 – A9},
publisher = {Elsevier Ltd},
abstract = {Laparoscopic liver resection is rapidly increasing, and certain types of resection are considered standard procedures for liver resection, especially for small malignant tumors located on the liver surface or in the anterolateral segments of the liver. Several specialized centers have performed many types of highly complex hepatectomies, anatomical resections, and laparoscopic donor hepatectomies. Even though several international consensus conferences and expert meetings have been held, until now there have been no practical guidelines for beginners or experts conducting laparoscopic liver resection. We describe here practical guidelines for performing laparoscopic liver resection, including the indications, technical considerations, and training required. © 2018 The Authors},
note = {Cited by: 43; All Open Access, Hybrid Gold Open Access},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2015
Wakabayashi G; Cherqui D; Geller D A; Buell J F; Kaneko H; Han H S; Asbun H; O'Rourke N; Tanabe M; Koffron A J; Tsung A; Soubrane O; Machado M A; Gayet B; Troisi R I; Pessaux P; Dam R M V; Scatton O; Hilal M A; Belli G; Kwon C H D; Edwin B; Choi G H; Aldrighetti L A; Cai X; Cleary S; Chen K; Schön M R; Sugioka A; Tang C; Herman P; Pekolj J; Chen X; Dagher I; Jarnagin W; Yamamoto M; Strong R; Jagannath P; Lo C; Clavien P; Kokudo N; Barkun J; Strasberg S M
Recommendations for laparoscopic liver resection: A report from the second international consensus conference held in morioka Journal Article
In: Annals of Surgery, vol. 261, no. 4, pp. 619 – 629, 2015, ISSN: 00034932, (Cited by: 831).
@article{Wakabayashi2015619,
title = {Recommendations for laparoscopic liver resection: A report from the second international consensus conference held in morioka},
author = {Go Wakabayashi and Daniel Cherqui and David A. Geller and Joseph F. Buell and Hironori Kaneko and Ho Seong Han and Horacio Asbun and Nicholas O'Rourke and Minoru Tanabe and Alan J. Koffron and Allan Tsung and Olivier Soubrane and Marcel Autran Machado and Brice Gayet and Roberto I. Troisi and Patrick Pessaux and Ronald M. Van Dam and Olivier Scatton and Mohammad Abu Hilal and Giulio Belli and Choon Hyuck David Kwon and Bjørn Edwin and Gi Hong Choi and Luca Antonio Aldrighetti and Xiujun Cai and Sean Cleary and Kuo-Hsin Chen and Michael R. Schön and Atsushi Sugioka and Chung-Ngai Tang and Paulo Herman and Juan Pekolj and Xiao-Ping Chen and Ibrahim Dagher and William Jarnagin and Masakazu Yamamoto and Russell Strong and Palepu Jagannath and Chung-Mau Lo and Pierre-Alain Clavien and Norihiro Kokudo and Jeffrey Barkun and Steven M. Strasberg},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84988493384&doi=10.1097%2fSLA.0000000000001184&partnerID=40&md5=0fb460d25e7ad44fd9e6b29fbdbd5c62},
doi = {10.1097/SLA.0000000000001184},
issn = {00034932},
year = {2015},
date = {2015-01-01},
urldate = {2015-01-01},
journal = {Annals of Surgery},
volume = {261},
number = {4},
pages = {619 – 629},
publisher = {Lippincott Williams and Wilkins},
abstract = {The use of laparoscopy for liver surgery is increasing rapidly. The Second International Consensus Conference on Laparoscopic Liver Resections (LLR) was held in Morioka, Japan, from October 4 to 6, 2014 to evaluate the current status of laparoscopic liver surgery and to provide recommendations to aid its future development. Seventeen questions were addressed. The first 7 questions focused on outcomes that reflect the benefits and risks of LLR. These questions were addressed using the Zurich-Danish consensus conference model inwhich the literature and expert opinion were weighed by a 9-member jury, who evaluated LLR outcomes using GRADE and a list of comparators. The jury also graded LLRs by the Balliol Classification of IDEAL. The jury concluded that MINORLLRs had become standard practice (IDEAL 3) and thatMAJORliver resections were still innovative procedures in the exploration phase (IDEAL 2b). Continued cautious introduction of MAJOR LLRswas recommended. All of the evidence available for scrutiny was of LOWquality by GRADE, which prompted the recommendation for higher quality evaluative studies. The last 10 questions focused on technical questions and the recommendations were based on literature review and expert panel opinion. Recommendations were made regarding preoperative evaluation, bleeding controls, transection methods, anatomic approaches, and equipment. Both experts and jury recognized the need for a formal structure of education for those interested in performing major laparoscopic LLR because of the steep learning curve. Copyright © 2015 Wolters Kluwer Health, Inc.},
note = {Cited by: 831},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2009
Buell J F; Cherqui D; Geller D A; O'Rourke N; Iannitti D; Dagher I; Koffron A J; Thomas M; Gayet B; Han H S; Wakabayashi G; Belli G; Kaneko H; Ker C; Scatton O; Laurent A; Abdalla E K; Chaudhury P; Dutson E; Gamblin C; D'Angelica M; Nagorney D; Testa G; Labow D; Manas D; Poon R T; Nelson H; Martin R; Clary B; Pinson W C; Martinie J; Vauthey J; Goldstein R; Roayaie S; Barlet D; Espat J; Abecassis M; Rees M; Fong Y; McMasters K M; Broelsch C; Busuttil R; Belghiti J; Strasberg S; Chari R S
Position on laparoscopic liver surgery Journal Article
In: Annals of Surgery, vol. 250, no. 5, pp. 825 – 830, 2009, ISSN: 15281140, (Cited by: 1068).
@article{Buell2009825,
title = {Position on laparoscopic liver surgery},
author = {Joseph F. Buell and Daniel Cherqui and David A. Geller and Nicholas O'Rourke and David Iannitti and Ibrahim Dagher and Alan J. Koffron and Mark Thomas and Brice Gayet and Ho Seong Han and Go Wakabayashi and Giulio Belli and Hironori Kaneko and Chen-Guo Ker and Olivier Scatton and Alexis Laurent and Eddie K. Abdalla and Prosanto Chaudhury and Erik Dutson and Clark Gamblin and Michael D'Angelica and David Nagorney and Giuliano Testa and Daniel Labow and Derrik Manas and Ronnie T. Poon and Heidi Nelson and Robert Martin and Bryan Clary and Wright C. Pinson and John Martinie and Jean-Nicolas Vauthey and Robert Goldstein and Sasan Roayaie and David Barlet and Joseph Espat and Michael Abecassis and Myrddin Rees and Yuman Fong and Kelly M. McMasters and Christoph Broelsch and Ron Busuttil and Jacques Belghiti and Steven Strasberg and Ravi S. Chari},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-70449411205&doi=10.1097%2fSLA.0b013e3181b3b2d8&partnerID=40&md5=6cfd227a8ec6241cd41ddcf3d33cd387},
doi = {10.1097/SLA.0b013e3181b3b2d8},
issn = {15281140},
year = {2009},
date = {2009-01-01},
urldate = {2009-01-01},
journal = {Annals of Surgery},
volume = {250},
number = {5},
pages = {825 – 830},
abstract = {Objective: To summarize the current world position on laparoscopic liver surgery. Summary Background Data: Multiple series have reported on the safety and efficacy of laparoscopic liver surgery. Small and medium sized procedures have become commonplace in many centers, while major laparoscopic liver resections have been performed with efficacy and safety equaling open surgery in highly specialized centers. Although the field has begun to expand rapidly, no consensus meeting has been convened to discuss the evolving field of laparoscopic liver surgery. Methods: On November 7 to 8, 2008, 45 experts in hepatobiliary surgery were invited to participate in a consensus conference convened in Louisville, KY, US. In addition, over 300 attendees were present from 5 continents. The conference was divided into sessions, with 2 moderators assigned to each, so as to stimulate discussion and highlight controversies. The format of the meeting varied from formal presentation of experiential data to expert opinion debates. Written and video records of the presentations were produced. Specific areas of discussion included indications for surgery, patient selection, surgical techniques, complications, patient safety, and surgeon training. Results: The consensus conference used the terms pure laparoscopy, handassisted laparoscopy, and the hybrid technique to define laparoscopic liver procedures. Currently acceptable indications for laparoscopic liver resection are patients with solitary lesions, 5 cm or less, located in liver segments 2 to 6. The laparoscopic approach to left lateral sectionectomy should be considered standard practice. Although all types of liver resection can be performed laparoscopically, major liver resections (eg, right or left hepatectomies) should be reserved for experienced surgeons facile with more advanced laparoscopic hepatic resections. Conversion should be performed for difficult resections requiring extended operating times, and for patient safety, and should be considered prudent surgical practice rather than failure. In emergent situations, efforts should be made to control bleeding before converting to a formal open approach. Utilization of a hand assist or hybrid technique may be faster, safer, and more efficacious. Indications for surgery for benign hepatic lesions should not be widened simply because the surgery can be done laparoscopically. Although data presented on colorectal metastases did not reveal an adverse effect of the laparoscopic approach on oncological outcomes in terms of margins or survival, adequacy of margins and ability to detect occult lesions are concerns. The pure laparoscopic technique of left lateral sectionectomy was used for adult to child donation while the hybrid approach has been the only one reported to date in the case of adult to adult right lobe donation. Laparoscopic liver surgery has not been tested by controlled trials for efficacy or safety. A prospective randomized trial appears to be logistically prohibitive; however, an international registry should be initiated to document the role and safety of laparoscopic liver resection. Conclusions: Laparoscopic liver surgery is a safe and effective approach to the management of surgical liver disease in the hands of trained surgeons with experience in hepatobiliary and laparoscopic surgery. National and international societies, as well as governing boards, should become involved in the goal of establishing training standards and credentialing, to ensure consistent standards and clinical outcomes.Copyright © 2009 by Lippincott Williams & Wilkins.},
note = {Cited by: 1068},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
- Ultimo aggiornamento della pagina: 23/03/2023