Pure laparoscopic liver resection reduces surgical site infections and hospital stay. Results of a case-matched control study in 50 patients

López‐Ben, Santiago; Palacios, Olga; Codina-Barreras, Antoni; Albiol, M.; Falgueras, Laia; Castro, Ernesto; Figueras, Joan

doi:10.1007/s00423-014-1169-7

Cited by 22 publications

(10 citation statements)

References 33 publications

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“…The incidence of transumbilical wound infections in Lap-H was 0% (0/42). Similarly, several studies have reported incidence rates of 0-11.8% (11)(12)(13)(14)(15)(16)(17). Thus, our results are comparable to previous reports.…”

Section: Discussionsupporting

confidence: 91%

Usefulness of a Transumbilical Incision for Organ Removal in Laparoscopic Hepatectomy

et al. 2020

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Background/Aim: To evaluate the complication rates and risk factors associated with transumbilical wounds and investigate the usefulness of an incision for organ removal in laparoscopic hepatectomy (Lap-H). Patients and Methods: We enrolled 42 patients who underwent Lap-H excluding a small partial resection in our hospital between 2013 and 2018. The occurrences of superficial surgical site infection (SSI) and transumbilical port-site incisional hernia were recorded. Results: SSI was not observed, and hernia occurred in 3 patients (7.14%). Univariate analysis revealed that body mass index (BMI) (p=0.004) was significantly associated with the risk of hernia formation. Conclusion: High BMI is a risk factor for hernia formation in patients undergoing Lap-H with transumbilical incision; hence, wound closure should be performed carefully. The construction of the transumbilical wound for organ removal was feasible with rationality, with no need to create a new wound.

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Section: Discussionsupporting

confidence: 91%

Usefulness of a Transumbilical Incision for Organ Removal in Laparoscopic Hepatectomy

et al. 2020

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“…Since the first report of a successful laparoscopic liver resection (LLR), diffusion of the laparoscopic approach in liver surgery has been slow because of initial concerns regarding operative risks, oncological issues and technical difficulties. Nevertheless, laparoscopy has now been shown to provide several advantages over laparotomy, including diminished blood loss, fewer complications and ascites, as well as shorter hospital stays. These benefits are thought to be related to the pneumoperitoneum, which limits blood loss and may enhance inflow occlusion when prior selective vascular inflow control is performed, but are also related to the absence of a large incision.…”

Section: Introductionmentioning

confidence: 99%

Risk factors and consequences of conversion in laparoscopic major liver resection

Cauchy

Fuks

Nomi

et al. 2015

British Journal of Surgery

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“…Use of silk sutures (14), postoperative bile leakage (3, 9, 15, 16), failure of the remnant liver (9), portal vein resection (1), preexisting bilioenteric anastomosis (17), and, interestingly, perioperative peritoneal lavage (18) have all been associated with increased rates of OSIs. In contrast, use of broad spectrum antibiotics in chemoprophylaxis (17) as cefuroxime alone confers no protection (19), employment of minimally invasive techniques (20), and avoidance of postoperative bile leak through the air leak test (21) seem to confer a prophylactic effect. Preexisting chronic liver disease and cirrhosis (22) and ERCP and stenting of the common bile duct (17) seem to have no effect on either SSI or OSI.…”

Section: Discussionmentioning

confidence: 99%

Incidence and Risk Factors for Organ/Space Infection after Radiofrequency-Assisted Hepatectomy or Ablation of Liver Tumors in a Single Center: More than Meets the Eye

et al. 2017

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IntroductionSurgical site infections (SSIs) and especially organ/space infection (O/SI) after resection or ablation of liver tumors are associated with increased morbidity and mortality. A secondary blood stream infection (BSI) is considered an O/SI but the exact prevalence is unknown. We aimed to investigate the incidence of O/SI and BSIs in a cohort of consecutive patients after liver resection or ablation, to seek for a possible connection between them and to search for potential risk factors.Materials and methodsWe reviewed all patients who underwent hepatic resection or intraoperative liver ablation between January 2012 and December 2016 in our department. We focused on age, gender, Child–Pugh score, preoperative biliary drainage, indication for surgery, type of resection, resection or ablation of tumor, need for bilioenteric reconstruction, additional procedure to hepatectomy, blood transfusion, operative time, postoperative admission to ICU, and antibiotic chemoprophylaxis. All positive cultures from intra-abdominal fluids and blood were recorded. O/SI and BSIs were diagnosed by the criteria set by Centers for Disease Control. All variables were compared between the group with O/SI and the group without infection. BSIs were associated with these infections also.ResultsEighty-one consecutive patients with a mean age of 64 years were enrolled. Fifteen patients presented a positive culture postoperatively: intra-abdominal fluid in eight, blood cultures in six, and both blood and intra-abdominal fluid in one patient. The directly estimated incidence of O/SI amounted to 11.1%. Four blood cultures were secondary to O/SI, and the remaining two secondary to central line catheter. O/SI was diagnosed indirectly, through the BSI in an additional 4.9% of the patients, raising the incidence of SSI to 16%. Among the factors studied, only admission to the ICU was found to be statistically significant as a risk factor for the development of O/SI (p = 0.026).ConclusionO/SI should be actively seeked for after liver surgery including blood cultures. Patients with affected physical status, comorbidities are in greater risk of developing O/SI.

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Pure laparoscopic liver resection reduces surgical site infections and hospital stay. Results of a case-matched control study in 50 patients

Abstract: In adequately selected patients, laparoscopic hepatectomy is feasible, safe, shortens hospital stay, and decreases surgical site infections.

Cited by 22 publications

References 33 publications

Usefulness of a Transumbilical Incision for Organ Removal in Laparoscopic Hepatectomy

Usefulness of a Transumbilical Incision for Organ Removal in Laparoscopic Hepatectomy

Risk factors and consequences of conversion in laparoscopic major liver resection

Incidence and Risk Factors for Organ/Space Infection after Radiofrequency-Assisted Hepatectomy or Ablation of Liver Tumors in a Single Center: More than Meets the Eye

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