Current Status of Laparoscopic Liver Resection: Experiences from Tertiary Center

Laparoscopic liver resection has been widely accepted nowadays for selective cases of liver diseases. Laparoscopic left lateral sectionectomy and minor LLR are considered standard practice worldwide and cautious introduction of major laparoscopic liver resections like hemihepatectomies, central sectionectomy etc.. in institutions having experienced liver surgeons. Because of increasing young liver donor, laparoscopic donor hepatectomy is becoming popular, which gives better cosmetic outcomes. Many clinical trials compared laparoscopic liver resection safety, long term outcomes with open procedures. More recently, advances in laparoscopic instruments and techniques encouraged Korean surgeons to choose a laparoscopic procedure as one of the treatment options for benign or malignant diseases of liver.

Current status of laparoscopic liver resection for hepatocellular carcinoma

Laparoscopic liver resection (LLR) is becoming widely accepted for the treatment of hepatocellular carcinoma (HCC). Laparoscopic left lateral sectionectomy and minor laparoscopic liver resection are now considered standard approaches, especially for tumors located in the anterolateral segments of the liver. Laparoscopic left lateral sectionectomy in adult donors is also gaining acceptance for child liver transplantation in many centers. Major LLRs, including left hepatectomy and right hepatectomy, have been recently attempted. Laparoscopic donor hepatectomy is becoming more popular owing to increasing demand from young living donors who appreciate its minimal invasiveness and excellent cosmetic outcomes. Several centers have performed total laparoscopic donor right hepatectomy in adult-to-adult living donor liver transplantation. Many meta-analyses have shown that LLR is better than open liver resection in terms of short-term outcomes, principally cosmetic outcomes. Although no randomized control trials have compared LLR with open liver resection, the long-term oncologic outcomes were similar for both procedures in recent case-matched studies.

Current status of laparoscopic liver resection for hepatocellular carcinoma

Laparoscopic liver resection (LLR) is becoming widely accepted for the treatment of hepatocellular carcinoma (HCC). Laparoscopic left lateral sectionectomy and minor laparoscopic liver resection are now considered standard approaches, especially for tumors located in the anterolateral segments of the liver. Laparoscopic left lateral sectionectomy in adult donors is also gaining acceptance for child liver transplantation in many centers. Major LLRs, including left hepatectomy and right hepatectomy, have been recently attempted. Laparoscopic donor hepatectomy is becoming more popular owing to increasing demand from young living donors who appreciate its minimal invasiveness and excellent cosmetic outcomes. Several centers have performed total laparoscopic donor right hepatectomy in adult-to-adult living donor liver transplantation. Many meta-analyses have shown that LLR is better than open liver resection in terms of short-term outcomes, principally cosmetic outcomes. Although no randomized control trials have compared LLR with open liver resection, the long-term oncologic outcomes were similar for both procedures in recent case-matched studies.