| Invited Lecture (JSGS) |
| Fri. November 2nd 9:00 - 9:40 Room 12: Kobe International Conference Center Main Hall |
| Advanced laparoscopic HBP surgery | |||
| Ho-Seong Han | |||
| Seoul National University, College of Medicine | |||
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| The trend in surgery has moved from open surgery to minimal invasive surgery. This trend also applies to HBP field as well. Laparoscopic surgery has been proved equivalent to open surgery in various fields in terms of oncologic safety. However, there are still few strong evidence supported by well-designed randomized studies in HBP fields. The reason for this is the number of cases is small that it is very difficult to perform large scaled study. Another reason is that laparoscopic surgery on HBP field is technically difficult. However, the application of laparoscopic surgery in this filed is rapidly expanding. The field of HBP surgery can be divided into Liver, Pancreas and Biliary field. Laparoscopic liver surgery is recently developed well. There has been 2 consensus meeting on laparoscopic liver resection. Laparoscopic left lateral sectionectomy was considered as standard procedure in 1st consensus meeting. Although there was still debate, laparoscopic liver resection as become attractive options for treatment of liver disease in 2nd consensus meeting. Numerous studies showed that oncologic outcomes are similar between laparoscopic and open liver resection in HCC. Some expert center can perform advanced laparoscopic liver surgery and majority of liver resection can be performed by minimal invasive ways. In minimally surgery for pancreas, distal pancreatectomy has become well recommended procedure in benign and borderline malignancy. However, there has been numerous reports that showed that laparoscopic distal pancreatectomy is efficient surgery in pancreas cancer located in body and tail. Although reports on laparoscopic PD is increasing, clinical application of this procedure is still scarce due to technical difficulty. However, more PD is performed in minimal invasive way including robotic assisted operation in the future. The laparoscopic surgery for biliary tract malignancy is still in early stages. The laparoscopic surgery for gallbladder cancer is still contraindicated, although there has been encouraging report from expert centers. The laparoscopic surgery for Klatskin tumor is still experimental procedure. However, this filed will be also dominated with the new tide of awesome and innovative procedure. There is nothing, which doesn’t change. Laparoscopic surgery in HBP filed is still evolving now. |
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