Department of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité - Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Langenbecks Arch Surg. 2020 Sep;405(6):725-735. doi: 10.1007/s00423-020-01918-8. Epub 2020 Jul 1.
Minimally invasive techniques have increasingly found their way into liver surgery in recent years. A multitude of mostly retrospective analyses suggests several advantages of laparoscopic over open liver surgery. Due to the speed and variety of simultaneous technical and strategic developments, it is difficult to maintain an overview of the current status and perspectives in laparoscopic liver surgery.
This review highlights up-to-date aspects in laparoscopic liver surgery. We discuss established indications with regard to their development over time as well as continuing limitations of applied techniques. We give an assessment based on the current literature and according to our own center experiences, not least with regard to a highly topical cost discussion.
While in the beginning mainly benign tumors were laparoscopically operated on, liver metastasis and hepatocellular carcinoma are now among the most frequent indications. Technical limitations remain and should be evaluated with the overall aim not to endanger quality standards in open surgery. Financial aspects cannot be neglected with the necessity of cost-covering reimbursement.
近年来，微创技术已越来越多地应用于肝外科手术中。大量的大多是回顾性分析表明腹腔镜手术比开腹手术具有多种优势。由于技术和策略的快速发展，很难掌握腹腔镜肝外科手术的现状和前景。
本综述重点介绍腹腔镜肝外科的最新进展。我们讨论了随着时间的推移，关于既定适应证的发展，以及不断出现的应用技术的局限性。我们根据目前的文献和我们自己中心的经验进行评估，尤其是关于当前热门的成本讨论。
虽然一开始主要是良性肿瘤采用腹腔镜手术，但肝转移和肝细胞癌现在是最常见的适应证之一。技术局限性仍然存在，应根据不危及开腹手术质量标准的总体目标进行评估。由于需要有成本覆盖的报销，经济方面不容忽视。
