Elmahi Eiad, Fairclough Samantha, Knifton Harry
General Surgery, Lincoln County Hospital, Lincoln, GBR.
General Surgery, North West Anglia NHS Foundation Trust, Peterborough, GBR.
Cureus. 2024 Nov 23;16(11):e74313. doi: 10.7759/cureus.74313. eCollection 2024 Nov.
The rapid advances in laparoscopic surgery have meant that formerly complex techniques are now commonly performed via this method. These practices are now becoming increasingly popular in the discipline of hepatopancreaticobiliary (HPB) surgery. One such example is liver resection, which is the focus of our review. We aimed to assess the rate of bile leak complications in minimally invasive liver resection compared to an open liver approach in malignant and benign conditions. A systematic review spanning the period from 2000 to 2022 was conducted, examining the postoperative complications in laparoscopic versus open liver resections. We searched the databases Medline, Cochrane, PubMed, and Google Scholar for relevant studies; 16 studies were included in the final analysis. Ten out of 16 studies that were included indicated that there was no significant difference in the rate of bile leaks. Five studies showed that bile leaks were found to occur more frequently in open surgery, and one study suggested that the rates were more common with the laparoscopic approach. The overall comparison of bile leak rates following open and minimally invasive liver resection suggests that there is no reduction in this complication in both types of surgery. As such, a laparoscopic or open method can both be adopted without any concerns for this particular complication.
腹腔镜手术的迅速发展意味着以前复杂的技术现在通常通过这种方法进行。这些做法现在在肝胰胆（HPB）外科领域越来越受欢迎。一个这样的例子是肝切除术，这是我们综述的重点。我们旨在评估与开放性肝手术相比，微创肝切除术在恶性和良性疾病中胆漏并发症的发生率。我们进行了一项涵盖2000年至2022年期间的系统综述，研究了腹腔镜与开放性肝切除术的术后并发症。我们在Medline、Cochrane、PubMed和谷歌学术数据库中搜索相关研究；最终分析纳入了16项研究。纳入的16项研究中有10项表明胆漏发生率没有显著差异。5项研究表明，开放性手术中胆漏更常见，1项研究表明腹腔镜手术中胆漏发生率更高。开放性和微创性肝切除术后胆漏率的总体比较表明，两种手术中这种并发症都没有减少。因此，腹腔镜或开放方法都可以采用，而无需担心这种特定的并发症。
