Laparoscopic major hepato-biliary-pancreatic surgery: formidable challenge to standardization.
BACKGROUND
Although laparoscopic colorectal or gastric surgery has become widely accepted as a superior alternative to conventional open surgery, the surgical management of hepato-biliary-pancreatic disease has traditionally involved open surgery. Recently, many reports have described laparoscopic partial liver resection, lateral segmentectomy, and distal pancreatectomy. However, laparoscopic major hepato-biliary-pancreatic surgery, such as hepatic lobectomy and pancreaticoduodenectomy, has not been widely developed because of technical difficulties.


METHODS
We describe our experience with laparoscopic major hepato-biliary-pancreatic surgery, including right hepatectomy using hilar Glissonean pedicle transaction, and pylorus-preserving pancreaticoduodenectomy.


CONCLUSIONS
Although our experience is limited, and randomized study is necessary to elucidate the appropriate indications for and effects of the present procedures, we believe that laparoscopic major hepato-biliary-pancreatic surgery can be feasible, safe, and effective in highly selected patients, and that it will be one of the standard therapeutic options for carefully selected patients with hepato-biliary-pancreatic disease.
Cho
Akihiro
A
Division of Gastroenterological Surgery, Chiba Cancer Center Hospital, 666-2 Nitonachou, Chuouku, Chiba, 260-8717, Japan. acho@chiba-cc.jp
Yamamoto
Hiroshi
H
Nagata
Matsuo
M
Takiguchi
Nobuhiro
N
Shimada
Hideaki
H
Kainuma
Osamu
O
Souda
Hiroaki
H
Gunji
Hisashi
H
Miyazaki
Akinari
A
Ikeda
Atsushi
A
Tohma
Tomoko
T
Matsumoto
Ikuko
I
D001652:Bile Ducts / Q000601:surgery; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods / Q000592:standards*; D008099:Liver / Q000601:surgery; D008488:Medical Illustration; D010179:Pancreas / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000379:methods*