Evolution of laparoscopic liver resection at Singapore General Hospital: a nine-year experience of 195 consecutive resections

Goh, Brian K. P.; Teo, Jin‐Yao; Chan, Chung‐Yip; Lee, Ser‐Yee; Cheow, Peng‐Chung; Chow, Pierce K. H.; Ooi, London L P J; Chung, Alexander Y. F.

doi:10.11622/smedj.2016188

Cited by 33 publications

(25 citation statements)

References 29 publications

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“…At our institution, we have been performing LLR since 2006, of which approximately 95% were undertaken from 2012 onwards. [ 22 23 24 25 26 27 ] The procedures which have been performed at our institution included many complex surgeries such as major liver resections, tumours in posterosuperior segments[ 23 ] and repeat liver resections for recurrent HCCs. [ 28 ] This relatively large experience has enabled us to confidently attempt LLR for srHCC.…”

Section: Discussionmentioning

confidence: 99%

Early experience with laparoscopic liver resection for spontaneously ruptured hepatocellular carcinoma

et al. 2020

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Introduction: There are limited data to date regarding laparoscopic liver resection (LLR) for spontaneously ruptured hepatocellular carcinoma (srHCC). We performed this study to determine the safety and feasibility of LLR for srHCC. Materials and Methods: We conducted a retrospective review of all patients who underwent liver resection for srHCC from 2000 to 2018. A total of five patients underwent LLR for srHCC, and they were matched to 10 patients who underwent open liver resection (OLR) for srHCC to perform a 1:2 comparison. A separate cohort of patients who underwent LLR for non-ruptured HCC (nrHCC) was also compared against the laparoscopic group. Results: The comparison between LLR versus OLR for srHCC demonstrated no significant differences in baseline characteristics between both groups. There was also no significant difference in perioperative outcomes such as median operating time, estimated blood loss (EBL), rate of blood transfusion, post-operative median length of stay (LOS), overall complication rates, major morbidity rates and 90-day mortality rates. Comparison between LLR for srHCC and LLR for nrHCC demonstrated no significant differences in baseline characteristics between both groups. There was also no significant difference in key perioperative outcomes such as median operating time, EBL, rate and volume of blood transfusion, median post-operative LOS, morbidity rates or mortality rates. Conclusion: LLR may be performed safely in selected cases of srHCC. These patients have comparable perioperative outcomes as those who undergo OLR for srHCC and LLR for nrHCC.

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Section: Discussionmentioning

confidence: 99%

Early experience with laparoscopic liver resection for spontaneously ruptured hepatocellular carcinoma

et al. 2020

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“…[10] However, with increasing advancement in surgical skills, techniques and equipment, it is becoming widely adopted for various types of surgery, including complex surgical procedures such as liver resections. [1112]…”

Section: Discussionmentioning

confidence: 99%

Short-term outcomes of minimally invasive surgery for patients presenting with suspected gallbladder cancer: Report of 8 cases

2019

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“…We first adopted MIPS in 2006 at our institution, but it was only since 2011 that 2 surgeons (Goh and Chan) decided to systematically adopt minimally invasive hepatopancreatobiliary surgery including MIPS. [ 7 26 27 28 ] The decision to perform MIPS was determined by an individual surgeon's preference after discussion and obtaining informed consent from the patient. This was not based on a standardised institution protocol.…”

Section: Methodsmentioning

confidence: 99%

Changing trends and outcomes associated with the adoption of minimally invasive pancreatic surgeries: A single institution experience with 150 consecutive procedures in Southeast Asia

et al. 2020

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Background: Minimally invasive pancreatic surgeries (MIPS) are increasingly adopted worldwide. However, it remains uncertain if these reported experiences are reproducible throughout the world today. This study examines the safety and evolution of MIPS at a single institution in Southeast Asia. Methods: This is a retrospective review of 150 consecutive patients who underwent MIPS between 2006 and 2018 of which 135 cases (90%) were performed since 2012. To determine the evolution of MIPS, the study population was stratified into 3 equal groups of 50 patients. Comparison was also made between pancreatoduodenectomies (PD), distal pancreatectomies (DP) and other pancreatic surgeries. Results: One hundred and fifty patients underwent MIPS (103 laparoscopic, 45 robotic and 2 hand-assisted). Forty-three patients underwent PD, 93 DP and 14 other MIPS. There were 21 (14.0%) open conversions. There was an exponential increase in caseload over the study period. Comparison across the 3 time periods demonstrated that patients were significantly more likely to have a higher American Society of Anesthesiologists score, older, undergo PD and a longer operation time. The conversion rate decreased from 28% to 0% and increased again to 14% across the 3 time periods. Comparison between the various types of MIPS demonstrated that patients who underwent PD were significantly older, more likely to have symptomatic tumours, had longer surgery time, increased blood loss, increased frequency of extended pancreatectomies, increased frequency of hybrid procedures, longer post-operative stay, increased post-operative morbidity rate and increased post-operative major morbidity rate. Conclusion: The case volume of MIPS increased rapidly at our institution over the study period. Furthermore, although the indications for MIPS expanded to include more complex procedures in higher risk patients, there was no change in key perioperative outcomes.

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Evolution of laparoscopic liver resection at Singapore General Hospital: a nine-year experience of 195 consecutive resections

Cited by 33 publications

References 29 publications

Early experience with laparoscopic liver resection for spontaneously ruptured hepatocellular carcinoma

Early experience with laparoscopic liver resection for spontaneously ruptured hepatocellular carcinoma

Short-term outcomes of minimally invasive surgery for patients presenting with suspected gallbladder cancer: Report of 8 cases

Changing trends and outcomes associated with the adoption of minimally invasive pancreatic surgeries: A single institution experience with 150 consecutive procedures in Southeast Asia

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