期刊
JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES
卷 29, 期 1, 页码 33-40出版社
WILEY
DOI: 10.1002/jhbp.1094
关键词
Glissonean approach; hepatic vein; liver anatomy; minimally invasive anatomic liver resection; segmentectomy
资金
- JSHBPS
Minimally invasive anatomic liver resection is still a challenging procedure, but there is a certain degree of consensus among expert liver surgeons. Most experts have over 11 years of experience with MILR and recommend techniques such as creating a demarcation line, indocyanine green negative staining method, and intraoperative ultrasound for identifying IPs.
Background Although the number of minimally invasive liver resections (MILRs) has been steadily increasing in many institutions, minimally invasive anatomic liver resection (MIALR) remains a complicated procedure that has not been standardized. We present the results of a survey among expert liver surgeons as a benchmark for standardizing MIALR. Method We administered this survey to 34 expert liver surgeons who routinely perform MIALR. The survey contained questions on personal experience with liver resection, inflow/outflow control methods, and identification techniques of intersegmental/sectional planes (IPs). Results All 34 participants completed the survey; 24 experts (70%) had more than 11 years of experience with MILR, and over 80% of experts had performed over 100 open resections and MILRs each. Regarding the methods used for laparoscopic or robotic anatomic resection, the Glissonean approach (GA) was a more frequent procedure than the hilar approach (HA). Although hepatic veins were considered essential landmarks, the exposure methods varied. The top three techniques that the experts recommended for identifying IPs were creating a demarcation line, indocyanine green negative staining method, and intraoperative ultrasound. Conclusion Minimally invasive anatomic liver resection remains a challenging procedure; however, a certain degree of consensus exists among expert liver surgeons.
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