Since the first introduction of laparoscopic cholecystectomy in late 1980’s, minimally invasive approach has made a revolutionary change of the practice of general surgery. However, the application of minimally invasive surgery (MIS) in advanced HPB procedures remained limited and slow progression despite of the recent advance of instrumentation.
Laparoscopic hepatectomy for malignant hepatic tumor is the last frontier in the minimally invasive surgery. Since the first introduction by Michelle Gagner in 1992, the progress of laparoscopic hepatectomy was slow and only gained minor acceptance among the hepatic surgeons in the past. This approach has been regarded to be technique demanding, time consuming with high conversion rate. The risk of intraoperative bleeding, air embolism and lack of effective parenchymal transection tools are all obstacles to wide spread of this approach. However, more and more literature reported successful experience of laparoscopic hepatectomy for benign as well as for malignant hepatic tumor recently. The intraoperative results, perioperative recovery and patient survival are all similar to those after traditional open hepatectomy. Some series reported decreased blood loss, fewer wound complication and shorter hospital stay after laparoscopic hepatectomy. Current indications for laparoscopic hepatectomy include the peripherally located tumors (segment 2,3,4b,5,6) with diameter less than 5 cm although some series of major liver resection have been reported.

　　Laparoscopic common bile duct procedures include choledocholithotomy, bilioenteric anastomosis and common bile duct resection for benign or malignant disease.
Laparoscopic pancreatic surgery remained the last frontier in the field of laparoscopic solid organ resection recently. Distal pancreatectomy with or without splenic vein preservation has been an established procedure with some advantages of MIS approach. Laparoscopic pancreatic head resection had been reported sporadically especially after the introduction of da Vinci robotic surgery.

　　More and more evidence have demonstrated the feasibility of the laparoscopic HPB surgery, especially after the recent introduction of new image system and instrumentation. However, these procedures are still technique demanding and complicated. Fully devoted, integrated team approach is recommended. Before that, advanced laparoscopic HPB procedure should be preserved for experienced experts.