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Recommendations for Laparoscopic Liver Resection A Report From the Second International Consensus Conference Held in Morioka

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单位: [1]Iwate Med Univ, Morioka, Iwate 0208505, Japan; [2]Hop Paul Brousse, Hepatobiliary Ctr, Villejuif, France; [3]Univ Pittsburgh, Pittsburgh, PA USA; [4]Tulane Univ Med Ctr Hosp & Clin, Tulane Transplant Inst, New Orleans, LA USA; [5]Louisiana State Univ, New Orleans, LA USA; [6]Louisiana State Univ, Med Ctr, New Orleans, LA USA; [7]Toho Univ, Sch Med, Tokyo, Japan; [8]Seoul Natl Univ, Bundang Hosp, Songnam, South Korea; [9]Mayo Clin, Jacksonville, FL USA; [10]Royal Brisbane Hosp, Herston, Qld, Australia; [11]Tokyo Med & Dent Univ, Tokyo, Japan; [12]Beaumont Hlth Syst, Troy, MI USA; [13]Univ Pittsburgh, Med Ctr, Pittsburgh, PA USA; [14]Beaujon Hosp, Clichy, France; [15]Hosp Sirio Libanes, Sao Paulo, Brazil; [16]Inst Mutualiste Montsouris, Paris, France; [17]Ghent Univ Hosp, Sch Med, Ghent, Belgium; [18]Inst Hosp Univ, Strasbourg, France; [19]Maastricht Univ, Med Ctr, NL-6200 MD Maastricht, Netherlands; [20]Hop La Pitie Salpetriere, Paris, France; [21]Southampton Univ Hosp Trust, Southampton, Hants, England; [22]Loreto Nuovo Hosp, Naples, Italy; [23]Sungkyunkwan Univ, Seoul, South Korea; [24]Univ Oslo, Oslo, Norway; [25]Yonsei Univ, Coll Med, Seoul, South Korea; [26]Hosp San Raffaele, I-20132 Milan, Italy; [27]Zhejiang Univ, Sir Run Run Shaw Hosp, Hangzhou 310003, Zhejiang, Peoples R China; [28]Univ Toronto, Toronto, ON M5S 1A1, Canada; [29]Far Eastern Mem Hosp, New Taipei City, Taiwan; [30]Klinikum Karlsruhe, Karlsruhe, Germany; [31]Fujita Hlth Univ, Toyoake, Aichi, Japan; [32]Pamela Youde Nethersole Eastern Hosp, Hong Kong, Hong Kong, Peoples R China; [33]Univ Sao Paulo, Sch Med, Sao Paulo, Brazil; [34]Hosp Italian Buenos Aires, Buenos Aires, DF, Argentina; [35]Huazhong Univ Sci & Technol, Tongji Hosp, Wuhan 430074, Peoples R China; [36]Paris South Univ Hosp, Orsay, France; [37]Mem Sloan Kettering Canc Ctr, New York, NY 10021 USA; [38]Tokyo Womens Med Univ, Tokyo, Japan; [39]Univ Queensland, Brisbane, Qld 4072, Australia; [40]Lilavati Hosp & Res Ctr India, Bombay, Maharashtra, India; [41]Univ Hong Kong, Hong Kong, Hong Kong, Peoples R China; [42]Univ Zurich Hosp, CH-8091 Zurich, Switzerland; [43]Univ Tokyo, Tokyo, Japan; [44]McGill Univ, Ctr Hlth, Quebec City, PQ, Canada; [45]McGill Univ, Quebec City, PQ, Canada; [46]Washington Univ, Sch Med, St Louis, MO USA; [47]Iwate Med Univ, Dept Surg, Sch Med, 19-1 Uchimaru, Morioka, Iwate 0208505, Japan
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关键词: anatomical resection colorectal liver metastasis donor hepatectomy hepatocellular carcinoma liver resection laparoscopic pneumoperitoneum robotic

摘要:
The use of laparoscopy for liver surgery is increasing rapidly. The Second International Consensus Conference on Laparoscopic Liver Resections (LLR) was held in Morioka, Japan, from October 4 to 6, 2014 to evaluate the current status of laparoscopic liver surgery and to provide recommendations to aid its future development. Seventeen questions were addressed. The first 7 questions focused on outcomes that reflect the benefits and risks of LLR. These questions were addressed using the Zurich-Danish consensus conference model in which the literature and expert opinion were weighed by a 9-member jury, who evaluated LLR outcomes using GRADE and a list of comparators. The jury also graded LLRs by the Balliol Classification of IDEAL. The jury concluded that MINOR LLRs had become standard practice (IDEAL 3) and that MAJOR liver resections were still innovative procedures in the exploration phase (IDEAL 2b). Continued cautious introduction of MAJOR LLRs was recommended. All of the evidence available for scrutiny was of LOW quality by GRADE, which prompted the recommendation for higher quality evaluative studies. The last 10 questions focused on technical questions and the recommendations were based on literature review and expert panel opinion. Recommendations were made regarding preoperative evaluation, bleeding controls, transection methods, anatomic approaches, and equipment. Both experts and jury recognized the need for a formal structure of education for those interested in performing major laparoscopic LLR because of the steep learning curve.

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出版当年[2014]版:
大类 | 1 区 医学
小类 | 1 区 外科
最新[2025]版:
大类 | 1 区 医学
小类 | 1 区 外科
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出版当年[2013]版:
Q1 SURGERY
最新[2023]版:
Q1 SURGERY

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第一作者单位: [1]Iwate Med Univ, Morioka, Iwate 0208505, Japan;
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通讯机构: [47]Iwate Med Univ, Dept Surg, Sch Med, 19-1 Uchimaru, Morioka, Iwate 0208505, Japan
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