Article Abstract

Technical aspects and surgical complications of laparoscopic liver resection

Authors: Minoru Nagayama, Toru Mizuguchi, Hiroshi Yamaguchi, Masafumi Imamura, Goro Kutomi, Kenji Okita, Toshihiko Nishidate, Ichiro Takemasa, Yasutoshi Kimura

Abstract

Laparoscopic liver resection (Lap LR) is widely used to perform various types of LR and has replaced open surgery in many cases. As far as the technique is concerned, Lap LR is more difficult than open LR. The difficulty score (DS) was developed as a tool for evaluating the technical complexity of Lap LR and has been validated in several studies. In this review, we validated the DS in our case series and used it to compare our series with those described in a previous report. Improvements in blood flow control methods have also played an important role in the expansion of the indications for Lap LR. We reviewed the development of the inflow blood control methods used during LR. Biliary stricture is the most significant complication after Lap LR. Unfortunately, heat injuries are unavoidable when a radiofrequency (RF) surgical device is used to achieve hemostasis. We reviewed the methods used to dissect the liver parenchyma and treat biliary stricture in one of our cases. Although Lap LR is less invasive than open LR, clinicians should monitor patients for biliary stricture, as it is a severe complication that requires multidisciplinary planning and management.

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