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Recommendations for laparoscopic liver resection: a report from the second international consensus conference held in Morioka.

Go Wakabayashi*Iwate Medical University, Morioka, Japan †Hepatobiliary Center-Paul Brousse Hospital, Villejuif, France ‡University of Pittsburgh, Pittsburgh, PA §Tulane Transplant Institute, Tulane Medical Center, and Louisiana State University and Medical Center, New Orleans, LA ¶Toho University School of Medicine, Tokyo, Japan ‖Seoul National University Bundang Hospital, Seongnam-si, South Korea **Mayo Clinic, Florida, FL ††Royal Brisbane Hospital, Queensland, Australia ‡‡Tokyo Medical and Dental University, Tokyo, Japan §§Beaumont Health System, Michigan, MI ¶¶University of Pittsburgh Medical Center, Pittsburgh, PA ‖‖Beaujon Hospital, Clichy, France ***Hospital Sirio Libanês, Sao Paulo, Brazil †††Institute Mutualiste Montsouris, France ‡‡‡Ghent University Hospital Medical School, Ghent, Belgium §§§Institut Hospitalo-Universitaire, Strasbourg, France ¶¶¶Maastricht University Medical Center, Maastricht, Netherlands ‖‖‖Pitie-Salpetriere Hospital, Paris, France ****Southampton University Hospital TruDaniel CherquiHôpital Paul BrousseDavid A. GellerUniversity of PittsburghJoseph E. BuellLouisiana State University and Medical CenterHironori KanekoToho University,Ho‐Seong HanHoracio J. AsbunMayo Clinic Rochester-MNNicholas O’RourkeRoyal Brisbane & Women's Hospital;Minoru TanabeTokyo Medical and Dental UnivAlan J. KoffronAllan Tsung‡University of Pittsburgh Medical CenterOlivier SoubraneHopital BeaujonMarcel Autran C. MachadoHospital Sirio-LibanesBrice GayetL'Institut Mutualiste MontsourisRoberto TroisiGhent UniversityPatrick PessauxInstitut de Recherche sur les Maladies Virales et HépatiquesRonald M. van DamOlivier ScattonIwate Medical UniversityMohammad Abu HilalUniversity Hospital Southampton NHS Foundation Trust#TAB#Giulio BelliLoreto Nuovo HospitalChoon Hyuck David KwonSungkyunkwan UniversityBjørn EdwinUniversity of Oslo#TAB#Gi Hong ChoiYonsei universityLuca AldrighettiIRCCS Ospedale San RaffaeleXiu-jun CaiZhejiang, UniversitySean ClearyUniversity of TorontoKuo‐Hsin ChenFar Eastern Memorial HospitalMichael R. SchoenKlinikum KarlsruheAtsushi SugiokaFujita Health UniversityC N TangPamela Youde Nethersole Eastern HospitalPaulo HermanUniversidade de Sao Paulo#TAB#Juan Pekoljhospital italiano de Buenos AiresXiaoping ChenHuazhong University of Science and Technology,Ibrahim DagherParis-South University HospitalWilliam R. JarnaginMemorial Sloan- Kettering Cancer CenterMasakazu YamamotoTokyo Women's Medical UniversityR StrongUniversity of QueenslandP. JagannathLilavati Hospital and Research Centre, MumbaiChung-Mau LoThe University of Hong KongPierre-Alain ClavienUniv. of ZurichNorihiro KokudoIwate Medical UniversityJeffrey BarkunMcGill UniversitySteven M. StrasbergWashington University – St Louis

2015en

ABI

Annotatsiya

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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DOI: 10.1097/sla.0000000000001184

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