Hepatobiliary-Pancreatic and Laparoscopic Surgical Unit, Southampton General Hospital, Southampton University Hospitals NHS Trust, Southampton, UK.
Am J Surg. 2011 Nov;202(5):e52-8. doi: 10.1016/j.amjsurg.2010.08.032. Epub 2011 Aug 20.
Few centers are undertaking major laparoscopic liver resections, because of the well-recognized technical difficulties and lack of training opportunities.
The authors describe their technique for laparoscopic right hepatectomy, highlighting relevant details for accomplishing a safe and efficient procedure. Patients were chronologically divided into 2 groups to evaluate the impact of increasing experience on the surgical outcomes.
Group I included 17 patients and group II 18 patients. The conversion rate to open or hybrid techniques significantly decreased from 36% in group I to 6% in group II (P = .03). The hospital stay decreased from a median of 6 days in group I to a median of 4 days in group II (P = .05). Complications occurred in 4 patients (11%), of whom 3 were in group I. The mortality was zero.
Laparoscopic right hepatectomy is a safe and efficient procedure when performed at specialized centers with extensive experience in hepatic surgery. Long-term training is necessary to acquire adequate expertise.
由于公认的技术难度和缺乏培训机会，很少有中心进行大规模的腹腔镜肝切除术。
作者描述了他们进行腹腔镜右半肝切除术的技术，强调了完成安全高效手术的相关细节。患者按时间顺序分为两组，以评估经验增加对手术结果的影响。
第 I 组包括 17 例患者，第 II 组包括 18 例患者。转为开腹或杂交技术的转化率从第 I 组的 36%显著降至第 II 组的 6%（P =.03）。第 I 组的住院时间中位数为 6 天，第 II 组为 4 天（P =.05）。有 4 例患者（11%）发生并发症，其中 3 例在第 I 组。无死亡病例。
当在具有丰富肝脏手术经验的专业中心进行时，腹腔镜右半肝切除术是一种安全有效的手术。需要长期培训才能获得足够的专业知识。
