%0 Journal Article
%T Laparoscopy in Liver Transplantation: The Future Has Arrived
%A Quirino Lai
%A Rafael S. Pinheiro
%A Giovanni B. Levi Sandri
%A Gabriele Spoletini
%A Fabio Melandro
%A Nicola Guglielmo
%A Marco Di Laudo
%A Fabrizio M. Frattaroli
%A Pasquale B. Berloco
%A Massimo Rossi
%J HPB Surgery
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/148387
%X In the last two decades, laparoscopy has revolutionized the field of surgery. Many procedures previously performed with an open access are now routinely carried out with the laparoscopic approach. Several advantages are associated with laparoscopic surgery compared to open procedures: reduced pain due to smaller incisions and hemorrhaging, shorter hospital length of stay, and a lower incidence of wound infections. Liver transplantation (LT) brought a radical change in life expectancy of patients with hepatic end-stage disease. Today, LT represents the standard of care for more than fifty hepatic pathologies, with excellent results in terms of survival. Surely, with laparoscopy and LT being one of the most continuously evolving challenges in medicine, their recent combination has represented an astonishing scientific progress. The intent of the present paper is to underline the current role of diagnostic and therapeutic laparoscopy in patients waiting for LT, in the living donor LT and in LT recipients. 1. Introduction In the last decades, laparoscopy has revolutionized the field of surgery. Video laparoscopy was officially born in 1987, when Professor Phillipe Mouret performed the first cholecystectomy in Lyons, France [1]. Many procedures previously performed with the open technique are now carried out with the laparoscopic approach. Several advantages are associated with laparoscopic surgery compared to open procedures: reduced pain due to smaller incisions and haemorrhaging, shorter hospital length of stay, and a lower incidence of wound infections are all arguments that gave strength to the widespread of laparoscopy. Similarly, liver transplantation (LT) has radically changed the care for many patients with hepatic end-stage diseases. The first human LT was performed in 1963 by Professor Thomas Starzl [2] in Denver, United States: however, due to its initial poor results, LT remained an experimental therapy for several years. Only introduction of cyclosporine [3] markedly improved patient outcomes, turning LT to a standard clinical treatment for more than fifty adult and paediatric liver pathologies and, at the same time, allowing to achieve excellent results in terms of survival. The intent of the present paper is to underline the current role of diagnostic and therapeutic laparoscopy in patients waiting for LT, in the living donor LT and in LT recipients. 2. Pretransplant Surgery 2.1. Laparoscopic Liver Resection The first nonanatomical laparoscopic hepatectomy was performed by Gagner in 1992 [4] and the first anatomical one by Azagra in 1996 [5].
%U http://www.hindawi.com/journals/hpb/2012/148387/