Comparative Short-term Benefits of Laparoscopic Liver Resection

Ciria, Rubén; Cherqui, Daniel; Geller, David A.; Briceño, Javier; Wakabayashi, Go

doi:10.1097/sla.0000000000001413

Cited by 639 publications

(481 citation statements)

References 171 publications

Supporting

Mentioning

440

Contrasting

Unclassified

Order By: Relevance

“…Zudem ist der technische Aufwand der erweiterten laparoskopischen Verfahren nicht unerheblich. Dennoch stieg die Zahl der Zentren mit Erfahrung in laparoskopischer Leberchirurgie in den letzten Jahren stark an und die Komplexität der durchgeführten Eingriffe hat nahezu das Niveau der offenen Chirurgie erreicht [8].…”

Section: Entwicklung Der Letzten Jahrenunclassified

“…Die verfügbaren Daten stammen aus multiplen Fallstudien [1,15], Fall-KontrollStudien [19], Übersichtsarbeiten [8] und Metaanalysen [21,23] …”

Section: Evidenz Der Laparoskopischen Leberchirurgieunclassified

“…Die weltweit größte Erfahrung in der laparoskopischen Leberchirurgie mit einer onkologischen Indikation liegt für Patienten mit hepatozellulären Karzinomen (HCC) vor [8]. Dies spiegelt zum einen die starke Verbreitung der minimalinvasiven Leberchirurgie in asiatischen Län-dern, mit einem hohen Anteil an Patienten mit lebereigenen Tumoren wider, zum anderen erscheint die Laparoskopie gerade bei diesen Patienten Vorteile zu versprechen [28,32].…”

Section: Hepatozelluläres Karzinomunclassified

See 2 more Smart Citations

Laparoskopische Leberchirurgie

Schön

Justinger

2017

Chirurg

View full text Add to dashboard Cite

Section: Entwicklung Der Letzten Jahrenunclassified

“…Die verfügbaren Daten stammen aus multiplen Fallstudien [1,15], Fall-KontrollStudien [19], Übersichtsarbeiten [8] und Metaanalysen [21,23] …”

Section: Evidenz Der Laparoskopischen Leberchirurgieunclassified

Section: Hepatozelluläres Karzinomunclassified

See 1 more Smart Citation

Laparoskopische Leberchirurgie

Schön

Justinger

2017

Chirurg

View full text Add to dashboard Cite

“…These benefits include less blood loss, less pain and analgesic requirement, shorter hospital stays, and improved cosmetic results 1, 2, 3, 4, 5, 6, 7. International Consensus Conferences on LLR have been held to evaluate the status of laparoscopic liver surgery, and these conferences have provided recommendations to aid in the future development of this procedure 8, 9.…”

Section: Introductionmentioning

confidence: 99%

“…In several previous studies, various procedures were assessed and discussed, particularly the learning curve, en bloc as a major LLR 3, 10, 11, 12, 13, 14, 15. The complexity of each major hepatectomy procedure differs widely, and the number of segments alone does not convey the complexity of a resection.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic left hemihepatectomy is suitable as a first step in pure laparoscopic major hepatectomy

Hasegawa

Nitta

Takahara

et al. 2018

Annals of Gastroent Surgery

View full text Add to dashboard Cite

AimAs a procedure, major laparoscopic liver resection (LLR) remains in the exploration phase. Previous studies have assessed major LLR en bloc, including hepatectomies of varying complexities; however, the number of segments alone does not convey the complexity of a resection. This study aimed to assess operative outcomes of LLR procedures with more than one sectionectomy, and to identify the best procedure as a first step when learning to carry out major LLR in order to make LLR a safer, more widely used procedure.MethodsWe carried out a retrospective review of the operative outcomes of 120 consecutive patients who underwent pure LLR with more than one sectionectomy. Operative outcomes were compared according to the complexity classification recently published, and the learning curve for each LLR procedure was assessed and compared.ResultsOperative outcomes, including operative time, blood loss, and the comprehensive complication index, were significantly stratified according to complexity. There were significant differences in operative outcomes among the medium complexity procedures. The operative time for left hemihepatectomy was the shortest, and the amount of blood loss was the lowest among the medium complexity LLR. Operative times for left hemihepatectomy shortened significantly with time and experience (r = −0.639), and the slope of the learning curve was steeper than for right hemihepatectomy and right posterior sectionectomy.ConclusionLeft hemihepatectomy is suitable as a first step in pure laparoscopic major hepatectomy and, given its safety and rapid learning curve for surgeons, it could become the gold standard procedure.

show abstract

Outcome and Learning Curve in 159 Consecutive Patients Undergoing Total Laparoscopic Hemihepatectomy

et al. 2016

View full text Add to dashboard Cite

28Importance 29Wide spread implementation of laparoscopic hemihepatectomy is currently limited by its 30 technical difficulty, paucity of training opportunities and perceived long and harmful learning 31 curve. Studies confirming the possibility of a short and safe learning curve for laparoscopic 32 hemihepatectomy could potentially benefit the further implementation of the technique. 33Objective 34To evaluate the extent and safety of the learning curve for laparoscopic hemihepatectomy. 35 Design 36A prospectively collected single-center database containing all laparoscopic liver resections 37 performed in our unit between 2003-2015 was retrospectively reviewed. 38 Setting 39Tertiary referral center, specialized in laparoscopic hepato-pancreato-biliary surgery. 40 Participants 41Included were all patients in whom a total laparoscopic right or left hemihepatectomy 42 procedure was started (intention-to-treat analysis), including laparoscopic extended 43 hemihepatectomies and hemihepatectomies with additional wedge resections. 44 Main Outcome and Measures 45Primary endpoints were clinically relevant complications (Clavien-Dindo grade ≥III). Presence 46 of a learning curve effect was assessed with a risk adjusted cumulative sum analysis. 47 Results 48Out of a total of 531 consecutive laparoscopic liver resections, 159 patients underwent total 49 laparoscopic hemihepatectomy, 105 right and 54 left. In a cohort with 67 (42%) males, 50 median age of 64 years (IQR 51-73)) and 110 (72%) resections for malignant lesions, the 51 overall median operation time was 330 minutes (270-391) and median blood loss 500 ml 52 conversions. 58 Conclusions and Relevance 59Total laparoscopic hemihepatectomy is a feasible and safe procedure with an acceptable 60 learning curve for conversions. Focus should now shift to providing adequate training 61 opportunities for centers interested in implementing this technique.

show abstract

Comparative Short-term Benefits of Laparoscopic Liver Resection

Cited by 639 publications

References 171 publications

Laparoskopische Leberchirurgie

Laparoskopische Leberchirurgie

Laparoscopic left hemihepatectomy is suitable as a first step in pure laparoscopic major hepatectomy

Outcome and Learning Curve in 159 Consecutive Patients Undergoing Total Laparoscopic Hemihepatectomy

Contact Info

Product

Resources

About