First 100 minimally invasive liver resections in a new tertiary referral centre for liver surgery

Barba, Giuliano La; Solaini, Leonardo; Radi, Giorgia; Mirarchi, Maria Teresa; D’Acapito, Fabrizio; Gardini, Andrea Casadei; Cucchetti, Alessandro; Ercolani, Giorgio

doi:10.4103/jmas.jmas_310_20

Cited by 3 publications

(1 citation statement)

References 27 publications

(26 reference statements)

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“…In all proposed cases the video clips represented the beginning of the procedure: In particular, the presented videos showed the area of Calot's triangle after the section of the peritoneal layer medial to the hepatic hilum toward the gallbladder pedicle. The grade of difficulty of the proposed cases was defined by the experience of the proposing center, which is an HPB hub for the region [17]. As such, the challenge in the identification of the extrahepatic biliary tree defined the grade of complexity of the presented case.…”

Section: Methodsmentioning

confidence: 99%

Fluorescence Cholangiography Using Indocyanine Green Improves the Identification of Biliary Structures During Laparoscopic Cholecystectomy

et al. 2022

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Background This cross‐sectional survey aimed to determine whether fluorescence cholangiography using indocyanine green (ICG‐FC) can improve the detection of the cystic duct and the main bile duct during laparoscopic cholecystectomy (LC). Methods The survey was distributed to 214 surgeons (residents/faculties) in 2021. The confidence in the identification of the cystic duct and of the main bile duct was elicited on a 10‐point Likert scale before/after the use of ICG‐FC. This was repeated for three LCs ranging from a procedure deemed easy to a LC for acute cholecystitis. Results There were 149 responses. ICG‐FC increased the responders’ confidence in identifying the cystic duct, raising the median value from 6 (IQR, 5–8) with white light up to 9 (IQR, 9–10) with ICG‐FC (paired p < 0.001). This increase was even more evident when identifying the main bile duct, where the median confidence value increased from 5 (IQR, 4–7) with white light to 9 (IQR, 8–10) with the use of ICG‐FC (p < 0.001). ICG‐FC significantly increased the detection of residents of the main bile duct in case of intermediate difficulty LCs and in LCs for acute cholecystitis. Conclusions The results support that the use of near‐infrared imaging can ameliorate detection of biliary structures, especially of the main bile duct and this was particularly true for young surgeons and in more complex situations.

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Section: Methodsmentioning

confidence: 99%

Fluorescence Cholangiography Using Indocyanine Green Improves the Identification of Biliary Structures During Laparoscopic Cholecystectomy

et al. 2022

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Implementation of a patient blood management in an Italian City Hospital: is it effective in reducing the use of red blood cells?

et al. 2022

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To evaluate the effect of patient blood management (PBM) since its introduction, we analyzed the need for transfusion and the outcomes in patients undergoing abdominal surgery for different types of tumor pre- and post-PBM. Patients undergoing elective gastric, liver, pancreatic, and colorectal surgery between 2017 and 2020 were included. The implementation of the PBM program was completed on May 1, 2018. The patients were grouped as follows: those who underwent surgery before the implementation of the program (pre-PBM) versus after the implementation (post-PBM). A total of 1302 patients were included in the analysis (445 pre-PBM vs. 857 post-PBM). The number of transfused patients per year decreased significantly after the introduction of PBM. A strong tendency for a decreased incidence of transfusion was evident in gastric and pancreatic surgery and a similar decrease was statistically significant in liver surgery. With regard to gastric surgery, a single-unit transfusion scheme was used more frequently in the post-PBM group (7.7% vs. 55% after PBM; p = 0.049); this was similar in liver surgery (17.6% vs. 58.3% after PBM; p = 0.04). Within the subgroup of patients undergoing liver surgery, a significant reduction in the use of blood transfusion (20.5% vs. 6.7%; p = 0.002) and a decrease in the Hb trigger for transfusion (8.5, 8.2–9.5 vs. 8.2, 7.7–8.4 g/dl; p = 0.039) was reported after the PBM introduction. After the implementation of a PBM protocol, a significant reduction in the number of patients receiving blood transfusion was demonstrated, with a strong tendency to minimize the use of blood products for most types of oncologic surgery.

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The Rate of Postoperative Bile Leak in Minimally Invasive Liver Resection in Comparison With Open Surgery: A Systematic Review

Elmahi,

Fairclough,

Knifton

2024

Cureus

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The rapid advances in laparoscopic surgery have meant that formerly complex techniques are now commonly performed via this method. These practices are now becoming increasingly popular in the discipline of hepatopancreaticobiliary (HPB) surgery. One such example is liver resection, which is the focus of our review. We aimed to assess the rate of bile leak complications in minimally invasive liver resection compared to an open liver approach in malignant and benign conditions. A systematic review spanning the period from 2000 to 2022 was conducted, examining the postoperative complications in laparoscopic versus open liver resections. We searched the databases Medline, Cochrane, PubMed, and Google Scholar for relevant studies; 16 studies were included in the final analysis.Ten out of 16 studies that were included indicated that there was no significant difference in the rate of bile leaks. Five studies showed that bile leaks were found to occur more frequently in open surgery, and one study suggested that the rates were more common with the laparoscopic approach. The overall comparison of bile leak rates following open and minimally invasive liver resection suggests that there is no reduction in this complication in both types of surgery. As such, a laparoscopic or open method can both be adopted without any concerns for this particular complication.

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First 100 minimally invasive liver resections in a new tertiary referral centre for liver surgery

Cited by 3 publications

References 27 publications

Fluorescence Cholangiography Using Indocyanine Green Improves the Identification of Biliary Structures During Laparoscopic Cholecystectomy

Fluorescence Cholangiography Using Indocyanine Green Improves the Identification of Biliary Structures During Laparoscopic Cholecystectomy

Implementation of a patient blood management in an Italian City Hospital: is it effective in reducing the use of red blood cells?

The Rate of Postoperative Bile Leak in Minimally Invasive Liver Resection in Comparison With Open Surgery: A Systematic Review

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