Biertho L, Waage A, Gagner M
Mount Sinai School of Medicine, Department of Surgery, Minimally Invasive Surgery Center, New York, NY, USA.
Ann Chir. 2002 Mar;127(3):164-70. doi: 10.1016/s0003-3944(01)00709-x.
To report the current indications and techniques of laparoscopic liver resections, and assess the results of this technique by reviewing international literature.
About 200 laparoscopic hepatectomies have been reported from 1991 to 2001. 102 resections were performed for malignant tumours, and 84 for benign tumours. Global conversion rate was 7% (13/186). Morbidity rate was 16.1% with two cases of possible gas embolisms (1.1%). Mortality rate was 0.54% (1/186 patients). Mean hospital stay was 7.7 days.
Laparoscopic hepatectomy is feasible, with a morbidity and mortality rate comparable to open procedures according to a careful selection of patients. However, prospective randomized trials are still needed to confirm those results, especially for resection of metastasis or malignant tumors. Evolution of laparoscopic hepatectomies will probably depend on the development of new techniques and instrumentations.
报告腹腔镜肝切除术的当前适应证和技术，并通过回顾国际文献评估该技术的结果。
1991年至2001年期间共报道了约200例腹腔镜肝切除术。其中102例为恶性肿瘤切除，84例为良性肿瘤切除。总体中转率为7%（13/186）。发病率为16.1%，有2例可能发生气体栓塞（1.1%）。死亡率为0.54%（1/186例患者）。平均住院时间为7.7天。
根据对患者的仔细选择，腹腔镜肝切除术是可行的，其发病率和死亡率与开放手术相当。然而，仍需要前瞻性随机试验来证实这些结果，特别是对于转移瘤或恶性肿瘤的切除。腹腔镜肝切除术的发展可能取决于新技术和器械的开发。
