There are several original variations in the technical aspects of LLH, and no accepted standard. The definition of major hepatectomy in laparoscopic liver surgery was expanded to resection including postero-superior segments 4a, 7, and 8 as they are difficult to access. Left hepatectomy and cholecystectomy were performed laparoscopically. Listing a study does not mean it has been evaluated by the U.S. Federal Government. The procedure began with a complete abdominal exploration and intraoperative liver ultrasonography, which allowed to identify the tumor between liver segments 2 and 4a in close contact with the left hepatic vein. After exploration of the abdominal cavity, the anterior approach was applied to dissect and clamp the left Glissonean pedicle below the hilar plate. Baker TB, Jay CL, Ladner DP, et al. When the tumor was located in segment 4, in- Lap: laparoscopy-assisted living donor hepatectomy, Open: open donor hepatectomy, RH: right lobe hepatectomy, LH: left lobe hepatectomy, and RH + LH: mixed group. Laparoscopic hepatectomy resulted in shorter operation time and postoperative hospital stay, and a lower postoperative morbidity rate, than open hepatectomy. Hepatectomy is done for hepatocellular carcinoma, benign tumor or cyst and for liver transplantation. After exploration of the abdominal cavity, the anterior approach was applied to dissect and clamp the left Glissonean pedicle below the hilar plate. World J Surg. Open left hepatectomy was performed through a reverse L-incision. While left- Laparoscopic liver surgery is becoming more popular, and many high-volume liver centers are now gaining expertise in this area. Search for more papers by this author. There were 424 patients who underwent MIS left hepatectomy, and 532 patients underwent open left hepatectomy. The principal steps in performing left hepatectomy are: 1 Hilar dissection of the left portal pedicle, either extrahepatic dissection or Glissonean pedicle transection, 2 Mobilization of the left liver, and 3 Liver transection along the middle hepatic vein. More ... Tozzi F, Berardi G, Vierstraete M, Kasai M, de Carvalho LA, Vivarelli M, et al. However, the advantages of laparoscopic left-sided hepatectomy (LLH) over open … Open left hepatectomy was performed through a re-verse L-incision. Left hepatectomy is the most common procedure in many laparoscopic series worldwide and is particularly suitable for minimally invasive surgery because the left hemiliver is more likely to be exposed during surgery owing to its smaller volume in the abdominal cavity, relatively independent and acute angle tract, and clear vasculature gradation. Physical examination showed no sign of congestive heart failure. Single-centre comparative study of laparoscopic versus open right hepatectomy. In addition, we will describe on detail our technique employed for right hepatectomy focusing on: ... First, the left portal vein tends to pass directly away from the operator and care must be taken not to injure it. Article Google Scholar 35. A retrospective review was conducted of 13, 10, and 11 consecutive patients who underwent robotic, laparoscopic, and open left‐side hepatectomy by the single surgeon. Background Surgery is established as only potentially curative treatment for hilar cholangiocarcinoma. An open extended left hepatectomy was planned therefore thorough cardiac assessment was undertaken. The aim of the present study is to compare the outcomes of left hepatectomy through laparoscopic and open approaches in left HCC. After 1 week, the animals were randomized to laparoscopic or open left lateral hepatectomy. In this study, we evaluated the practice of laparoscopic hepatectomy with the left jackknife position for patients with HCC located in segment VI, VII, or VIII. Code 47122 also is reported for a left trisegmentectomy, which consists of the removal of the left liver lobe (segments II, III, and IV) along with the right anterior segments (V and VIII). Left hepatectomy is one of the most standard types of hepatectomy, and the skills required for this operation are the basic ones for accomplishing any type of liver resec-tion. Oxygen saturation in room air was 93–98% with a respiratory rate of 14 per minute. Four cases had bile leakage, which resolved after 1 month. An extended left hepatectomy involves the further resection of segments 5 and 8. The aim of this study is to assess the safety and effectiveness of the technique developed at … The resulting cancer is called hepatocellular carcinoma or malignant hepatoma. Kyung-Suk Suh, The aims of this study were to assess our results of laparoscopy-assisted left lateral hepatectomy for hepatocellular carcinoma (HCC) and to compare them with those of open conventional procedures. 1. Purposes: For the first time in China, the current study was designed to compare the clinical outcomes between Chinese patients receiving hepatectomy with or without the enhanced recovery after surgery (ERAS) strategy.Methods: The current study enrolled 250 patients who would receive hepatectomy. Laparoscopic hepatectomy for hepatocellular carcinoma (HCC) located in segment VI, VII, or VIII of the liver is usually difficult because of poor operative exposure, due to the unique anatomical structure. 11Mid-term overall survival comparison (Kaplan-Meier method) between laparoscopic right hepatectomy (LRH) and open right hepatectomy (ORH) for colorectal carcinoma liver metastases (p= 0.283; log-rank test) . After exploration of the abdominal cavity, the anterior approach was applied to dissect and clamp the left Glissonean pedicle below the hilar plate. A total of 40 consecutive laparoscopically started hemi-hepatectomy (intention-to-treat analysis) cases between August 2012 and October 2015 were matched against open cases using the following criteria: laterality of surgery and pathology (essential criteria); American Society of Anesthesiologists score, body mass index, pre-operative bilirubin, neo-adjuvant chemotherapy, … Laparoscopic left hepatectomy (liver segments 2, 3, and 4) was decided upon. Under general anesthesia, the patient was placed in a supine position. 2. In one case, a left intercostal trocar (5 mm) was introduced for recurrent hepatocellular carcinoma in segment II after open right hemi-hepatectomy . However, its perioperative and oncological outcomes have not been evaluated in left hepatectomy patients. RESEARCH Open Access Right-side versus left-side hepatectomy for the treatment of hilar cholangiocarcinoma: a comparative study Hye-Sung Jo, Dong-Sik Kim*, Young-Dong Yu, Woo-Hyoung Kang and Kyung Chul Yoon Abstract Background: Radical resection is the only curative treatment for patients with hilar cholangiocarcinoma. Suprahepatic IVC. 9 Abu Hilal M, Di Fabio F, Teng MJ, et al. Marubashi S, Wada H, Kawamoto K, et al. Four ports were placed. Hepatectomy is the surgical resection (removal of all or part) of the liver. Few groups apply the Glissonian pedicle for open donor hepatectomy (14,15), and only our group have adopted it for PLDH . Left-sided hepatectomy is a novel, minimally invasive operative technique for primary left-sided hepatolithiasis, but it has not been accepted widely due to the limited information about short- and long-term outcomes, effectiveness, and safety compared with the open approach. While the term is often employed for the removal of the liver from a liver transplant donor, this article will focus on partial resections of hepatic tissue and hepatoportoenterostomy . METHODS: From December 2012 to October 2016, laparoscopic left hepatectomy (LLH) was performed in 40 patients and open left hepatectomy (OLH) was performed in 80 patients. Laparoscopic versus open approach for formal right and left hepatectomy: a propensity score matching analysis. Pure Laparoscopic Versus Open Left Hepatectomy Including the Middle Hepatic Vein for Living Donor Liver Transplantation. And these approaches could be even more useful in the laparoscopic context. World J Surg 2013;37:2202-10. 2018;42(8):2627–34. This may require removing the entire right or left lobe, or even larger portions of the liver. Materials and Methods: A systematic literature research was performed to identify comparative studies on LLH … The inclusion criteria were as follows: (1) studies comparing between LMH and OMH, defined as right hepatectomy or left hepatectomy according to the Brisbane 2000 Nomenclature 29; (2) studies reporting on benign and/or malignant disease with a clear description of the indications; (3) studies reporting on the perioperative short-term outcomes with a clear description of the results; and … Left-sided hepatectomy is an effective treatment for left intrahepatic bile duct stones with irreversible disease, such as biliary strictures, severe parenchymal fibrosis or atrophy. A substantial amount of experience in both oncologic liver resection and open living-donor hepatectomy is necessary in order to undertake laparoscopic LDH. Tozzi F, Berardi G, Vierstraete M, Kasai M, de Carvalho LA, Vivarelli M, et al. A right (segments V-VIII) or extended right (segments IV-VIII) hepatectomy (see Chapter 18 and Fig. However, whether hepatectomy should be preferred to the left-side hepatectomy, which includes left hemihepatectomy, extended left hemihepatectomy, and left … Safety and feasibility of laparoscopic left hepatectomy for the treatment of hepatolithiasis in patients with previous abdominal surgery Lingpeng Liu, Yong Huang, Zigang Ding, Bangran Xu, Dilai Luo, Hu Xiong, Hongliang Liu, Mingwen Huang Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, China The operation time was 277.23 min, and four cases were converted to an open hepatectomy for bleeding. The aim of the present study is to compare the outcomes of left hepatectomy through laparoscopic and open approaches in left HCC. A liver resection is the surgical removal of all or a portion of the liver. In open liver surgery, the definition of major hepatectomy was a resection of 3 or more Couinaud segments. Methods: The study included 5 patients who underwent totally laparoscopic left hepatectomy between July 2016 and September 2017. During the procedure, a replaced left hepatic artery was visualized and dissected to the level of its origin from the left gastric artery. Open left hepatectomy. The mean of hospital days was 9.80. Laparoscopic Versus Open Left Hemihepatectomy for Liver Benign Lesions The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. The present meta-analysis aimed to compare the surgical and oncological outcomes of LH with those of open hepatectomy (OH) for HCC with cirrhosis.MethodsThe PubMed, Embase, and Cochrane Library databases were searched … In this case with a left intercostal trocar, the diaphragmatic port site was laparoscopically closed with an absorbable suture because the site was not covered by the remnant liver. Open left-sided hepatectomy. Left hemihepatectomy is more challenging and is most usually performed by an open surgery, although more expert laparoscopic surgeons are beginning to carry it out. Many studies, including meta-analyses, have confirmed the benefits of LH in comparison with open hepatectomy, namely: lower levels of postoperative pain, fewer peritoneal adhesions, shorter hospital stay, earlier return to daily activities, lower blood loss, reduced morbidity, fewer operative complications and less mortality [2-15,18-29]. Background: Although laparoscopic left hepatectomy (LLH) for hepatolithiasis had been successfully performed in a series of cases, its advantages over open left hepatectomy (OLH) are still uncertain. Suk Kyun Hong, Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea. In this chapter, we will give the evolution of the technique used for the standard open right hepatectomy. Background: The short- and long-term prognoses are unclear following laparoscopic major hepatectomy (LMH) for hepatocellular carcinoma (HCC). As only one RCT was included, the evidence of which is still limited. Open versus Laparoscopic Left-sided Hepatectomy (OLLEH) trial Multi-institutional, prospective and randomized trial in patients undergoing left sided hepatectomy through laparoscopic versus open procedure. In subgroup analysis of minor hepatectomy, major hepatectomy, size of lesion less than 3 cm or 3 cm and above, well and moderately/poorly differentiated tumours, survival was similar between groups . J Gastrointest Surg 2011;15:818-23. Right-lobe hepatectomy is now the predominant form of adult-to-adult laparoscopic LDH, owing to the frequent need for large-volume grafts to accommodate adult body sizes. The procedure, initially described by Seneque and his colleagues [1], consists of three parts: hilar dissection of the left portal pedicle, mobilization of the left liver, and Laparoscopy-assisted and open living donor right hepatectomy: a comparative study of outcomes. Laparoscopic left hemihepatectomy (LLH) may be an alternative to open (OLH). Of the 61 patients with hepatolithiasis, 28 underwent LLH (LLH group) and 33 underwent open left hepatectomy (OLH group). Extended left hepatectomy (resection of Couinaud segments II, III, IV, V, and VIII of the liver) has only slowly been appreciated as a viable resectional technique for large, strategically placed, left-sided and central hepatic lesions that extend to involve the right anterior sectoral portal pedicular structures. Consider vitamin K (10 mg IV or SQ), which will not help during surgery but which may benefit the patient within 24 h (note that coagulopathy peaks at ~ … KS, a 31-year-old woman with mild gastroesophageal reflux disease requiring no home medications, presented for planned open left hepatectomy (our preferred technique at the time) for liver donation.

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