Minimally Invasive Surgery in Hepato-Biliary-Pancreatic Disease.
10.5124/jkma.2003.46.8.715
- Author:
Ho Seong HAN
1
Author Information
1. Department of General Surgery, Seoul National University College of Medicine, Bundang Hospital, Korea. hanhs@SNUBH.org
- Publication Type:Original Article
- Keywords:
Laparoscopic surgery;
Cholecystectomy;
CBD exploration;
Pancreatic disease;
Liver resection
- MeSH:
Ampulla of Vater;
Biliary Tract Diseases;
Cholecystectomy;
Cholecystectomy, Laparoscopic;
Cholecystitis;
Cholecystitis, Acute;
Choledochostomy;
Gallbladder;
Laparoscopy;
Liver;
Pancreatectomy;
Pancreatic Diseases;
Pancreaticoduodenectomy;
Surgical Procedures, Minimally Invasive*
- From:Journal of the Korean Medical Association
2003;46(8):715-721
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
The indication of laparoscopic procedure is continuously extending in the field of hepato-biliary-pancreatic surgery. Laparoscopic cholecystectomy has become a standard treatment for the disease of the gallbladder. Its application has widened to include conditions that once considered to be relative contraindications of laparoscopic cholecystectomy such as acute cholecystitis, complicated cholecystitis, previous operation history, and old age. Recently, a laparoscopic CBD exploration has been used for the treatment of CBD stone disease with good results. This operation may obviate the risk of immediate and long-term problem of sphincterotomy of the Ampulla of Vater resulting from endoscopic extraction of the CBD stone. For the biliary tract disease, pioneering operation of the laparoscopic IHD exploration and Roux-en-Y choledochojejunostomy have been successfully performed in our country. In terms of laparoscopic pancreatic surgery, a cystogastrostomy and a distal pancreatectomy are feasible operations. However, its indication is limited to benign or pre-malignant diseases. A pancreaticoduodenectomy with a laparoscopic technique is still not recommended. For the laparoscopic surgery of the liver, it has been initially applied to unroofing of a liver cyst or wedge resection. However, anatomic liver resections were successfully performed. The parenchymal dissection of the liver has been possible with the development of innovative laparoscopic equipments. Liver resection can be done with a laparoscopy-assisted method or a totally laparoscopic method. With accumulation of experience and the development of equipments, laparoscopic surgery has become a major operative tool in the hepato-biliary-pancreatic disease with an advantage of minimal invasiveness.
