Department of General Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Curr Opin Organ Transplant. 2019 Apr;24(2):167-174. doi: 10.1097/MOT.0000000000000609.
Many institutions have started or are planning to start a purely laparoscopic right hepatectomy (PLRH) for adult living donor recipients but the experience is relatively very limited. The present review will look at the current status of PLRH and go over some of the technical details important for a safe operation. Necessary elements and different strategies to start a safe and reproducible PLRH program will be discussed.
Several publications with a relatively large number of cases have been published in the last few years. The initial results of PLRH seem to be comparable to open donor hepatectomy when performed by surgeons with sufficient expertise laparoscopic and donor hepatectomy.
With the ongoing accumulation of experience in laparoscopic liver surgery and living donor liver transplantation, it is most likely that PLRH will be performed more widely than the present time. Institutions should implement a step-by-step approach with proctorship, standardization of surgical procedures and a balanced selection criterion for donors for a safe transition from open method to a PLRH program.
许多机构已经开始或计划开始为成人活体供体受者进行单纯腹腔镜右半肝切除术（PLRH），但经验相对非常有限。本次综述将探讨 PLRH 的现状，并介绍一些安全手术的重要技术细节。将讨论开展安全、可重复的 PLRH 计划所需的要素和不同策略。
过去几年发表了几篇具有较大病例数的出版物。PLRH 的初步结果似乎与由具有足够腹腔镜和供体肝切除术专业知识的外科医生进行的开放性供体肝切除术相当。
随着腹腔镜肝外科和活体供肝移植经验的不断积累，PLRH 的开展范围很可能比目前更广泛。机构应该采用逐步实施的方法，在有指导医师的情况下进行，规范手术程序，并为供体选择平衡的标准，以安全地从开放性方法过渡到 PLRH 计划。
