Impact of liver cirrhosis, the severity of cirrhosis, and portal hypertension on the outcomes of minimally invasive left lateral sectionectomies for primary liver malignancies

Coelho, Fabrício Ferreira; Herman, Paulo; Krüger, Jaime; Wu, Andrew G.R.; Chin, Ken Min; Hasegawa, Kiyoshi; Zhang, Wanguang; Alzoubi, M.; Aghayan, Davit L.; Siow, Tiing-Foong; Scatton, Olivier; Kingham, T. Peter; Marino, Marco Vito; Mazzaferro, Vincenzo; Chiow, Adrian Kah Heng; Sucandy, Iswanto; Ivanecz, Arpad; Choi, Sung Hoon; Lee, Jae Hoon; Gastaca, Mikel; Vivarelli, Marco; Giuliante, Felice; Ruzzenente, Andrea; Yong, Chee-Chien; Dokmak, Safi; Fondevila, Constantino; Ефанов, Михаил; Morise, Zenichi; Benedetto, Fabrizio Di; Brustia, Raffaele; Valle, Raffaele Dalla; Boggi, Ugo; Geller, David A.; Belli, Andrea; Méméo, Riccardo; Gruttadauria, Salvatore; Mejía, Alejandro; Park, James O.; Rotellar, Fernando; Choi, Gi Hong; Robles‐Campos, Ricardo; Wang, Xiaoying; Sutcliffe, Robert P.; Pratschke, Johann; Chong, Charing C.N.; D’Hondt, Mathieu; Monden, Kazuteru; Ben, Santiago López; Liu, Rong; Ferrero, Alessandro; Ettorre, Giuseppe Maria; Cipriani, Federica; Cherqui, Daniel; Liang, Xiao; Soubrane, O.; Wakabayashi, Go; Troisi, Roberto; Yin, Mengqiu; Cheung, Tan‐To; Sugioka, Atsushi; Han, Ho‐Seong; Long, Tran Cong Duy; Fuks, David; Hilal, Mohammed Abu; Chen, Kuo-Hsin; Aldrighetti, Luca; Edwin, Bjørn; Goh, Brian K. P.; Syn, Nicholas; Prieto, Mikel; Meurs, Juul; Meyere, Céline De; Lee, Kit‐Fai; Salimgereeva, Diana; Alikhanov, Ruslan; Kato, Yutaro; Kojima, Masayasu; Robert, Margarida Casellas I; Lee, Boram; D’Silva, Mizelle; Saleh, Mansour; Pascual, Franco; Ardito, Francesco; Citterio, Davide; Mocchegiani, Federico; Berardi, Giammauro; Colasanti, Marco; Guzmán, Yoelimar; Labadie, Kevin P.; Conticchio, Maria; Dogeas, Epameinondas; Kauffmann, Emanuele Federico; Giuffrida, Mario; Laurent, Alexis; Magistri, Paolo; Mishima, Kazuo; Schmelzle, Moritz; Krenzien, Felix; Kadam, Prashant; Lai, Eric C. H.; Ghotbi, Jacob; Fretland, Åsmund Avdem; Forchino, Fabio; Mazzotta, Alessandro; Cauchy, François; Kawaguchi, Yoshikuni; Lim, Chetana; Valle, Bernardo Dalla; Liu, Qu; Zheng, Junhao; Phan, Nghia Phuoc; Chen, Zewei; Yu, Shian

doi:10.1016/j.surg.2023.04.057

Cited by 6 publications

(2 citation statements)

References 49 publications

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“…However, another retrospective multicenter study about minimally invasive left lateral sectionectomies showed that in comparing Child-Pugh A patients to patients without cirrhosis, operative times were longer, intraoperative blood loss and transfusion rates were higher, and hospital stays were longer. On the flip side, perioperative outcomes did not significantly differ with respect to extent of liver cirrhosis (Child-Pugh A 753 patients vs. Child-Pugh B 58 patients) [55].…”

Section: Technical Adjustmentsmentioning

confidence: 85%

Hepatocellular Carcinoma: The Role of Surgery in Liver Cirrhosis

Koch,

Horné,

Fabritius

et al. 2024

Visc Med

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Background: Liver surgery is an essential component of hepatocellular carcinoma (HCC) treatment. Advances in surgical techniques and perioperative care have improved outcomes and have helped to expand surgical indications. However, liver fibrosis and cirrhosis still remain major problems for liver surgery due to the relevant impact on liver regeneration of the future liver remnant (FLR) after surgery. Especially in patients with clinically significant portal hypertension due to liver cirrhosis, surgery is limited. Despite recent efforts in developing predictive models, estimating the postoperative hepatic function remains difficult. Summary: In this review, we focus on the role of surgery in the treatment of HCC in structurally altered livers. The importance of assessing FLR with techniques such as contrast-enhanced CT, e.g., with the help of artificial intelligence is highlighted. Moreover, strategies for increasing the FLR with approaches like portal vein embolization and liver vein deprivation prior to surgery are discussed. Patient selection, minimally invasive liver surgery including robotic techniques, and perioperative concepts like the Enhanced Recovery After Surgery (ERAS) guidelines are identified as crucial parts of avoiding posthepatectomy liver failure. Key Message: The need for ongoing research to optimize patient selection criteria and perioperative care and to develop innovative biomarkers for outcome prediction is emphasized.

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Section: Technical Adjustmentsmentioning

confidence: 85%

Hepatocellular Carcinoma: The Role of Surgery in Liver Cirrhosis

Koch,

Horné,

Fabritius

et al. 2024

Visc Med

View full text Add to dashboard Cite

show abstract

“…Consistently, the latest Barcelona Clinic Liver Cancer (BCLC) staging system update in 2022 opened to a comprehensive evaluation of the liver function, including the role of portal hypertension and functionality of the FLR in the therapeutic algorithm ( 3 ). Minimally invasive surgery, either laparoscopic or robotic, has a relevant role in this specific setting thanks to the preservation of porto-systemic shunts, reduction of liver decompensation and lower impact on the abdominal wall ( 4 ).…”

mentioning

confidence: 99%