Pure laparoscopic right hepatectomy: A risk score for conversion for the paradigm of difficult laparoscopic liver resections. A single centre case series

Cipriani, Francesco; Ratti, Francesca; Fiorentini, Guido; Catena, Marco; Paganelli, Michele; Aldrighetti, Luca

doi:10.1016/j.ijsu.2020.08.013

Cited by 13 publications

(13 citation statements)

References 42 publications

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“…Literature search yielded 1895 unique articles, of which 35 3,6‐14,19‐43 were shortlisted after title and abstract screen for full text review (Figure 2). An additional two articles were identified through screening of references, 17,18 and three were identified by co‐authors 44‐46 .…”

Section: Resultsmentioning

confidence: 99%

“…51 Our systematic review found 11 unique DSS. 3,[6][7][8][9][20][21][22][23] The Ban and Iwate DSS were based on traditional variables associated with difficult resections including resection extent, tumor location and size, liver function, proximity to major vessels, and subsequent use of HALS or hybrid method. The Hasegawa DSS is based on the effect of resection extent, tumor location, obesity, and platelet count on surgical time.…”

Section: Discussionmentioning

confidence: 99%

“…Studies comparing DSS did not establish a clear superior DSS and found all DSS to be predictive of the surrogates of difficulty to some extent. The other novel DSS by Kinoshita el al, 20 Russolillo et al, 21 Cipriani et al, 22 Mosteanu et al, 44 Onda et al, 23 and Tong et al 45 have thus far not been validated. Several studies were performed to validate the use of the various DSS in specific scenarios.…”

Section: Discussionmentioning

confidence: 99%

“…A total of 11 studies 3,[6][7][8][9][20][21][22][23]44,45 reported on the formulation of unique DSS for MILR (Table 1). Ban et al 6 proposed the first DSS in 2014 with the objective of guiding new surgeons adopting MILR in progressing from straightforward to technically complex LLR.…”

Section: Formulation Of Dssmentioning

confidence: 99%

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Systematic review and meta‐analysis of difficulty scoring systems for laparoscopic and robotic liver resections

Linn

Han

et al. 2022

J Hepato Biliary Pancreat

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Introduction:The ability to stratify the difficulty of minimally invasive liver resection (MILR) allows surgeons at different phases of the learning curve to tackle cases of appropriate difficulty safely. Several difficulty scoring systems (DSS) have been formulated which attempt to accurately stratify this difficulty. The present study aims to review the literature pertaining to the existing DSS for MILR. Methods:We performed a systematic review and metanalysis of the literature reporting on the formulation, supporting data, and comparison of DSS for MILR.Results: A total of 11 studies were identified which reported on the formulation of unique DSS for MILR. Five of these (Ban, Iwate, Hasegawa, Institut Mutaliste

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Formulation Of Dssmentioning

confidence: 99%

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Systematic review and meta‐analysis of difficulty scoring systems for laparoscopic and robotic liver resections

Linn

Han

et al. 2022

J Hepato Biliary Pancreat

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“…In recent years, an unparalleled growth of laparoscopic procedures in the field of liver resections has been witnessed [ 24 , 25 ]. The well-established advantages of a pure laparoscopic approach such as decreased postoperative pain, shorter length of hospital stay, better preservation of abdominal wall integrity, and earlier return to daily activities are readily perceived when applied to benign hepatic lesions [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

The Two-Step Treatment for Giant Hepatic Hemangiomas

Corte

Marino

Ratti

et al. 2021

JCM

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The aim of the present study is to analyze the feasibility and the impact of a two-step approach in the treatment of giant hemangiomas (GH) i.e., exceeding 10 cm in maximum diameter, consisting of transarterial embolization (TAE) followed by laparoscopic liver resection (LLR). Ten patients with 11 GH were treated with TAE and subsequent LLR between 2017 and 2020 (Group A). A matched cohort of 10 patients with GH treated with upfront LLR between 2014 and 2017 was identified for comparison (Group B). Data were analyzed regarding intraoperative and postoperative outcomes, including successful completion of LLR, morbidity, and mortality. Successful microparticle embolization of the GH-feeding arteries was performed in all patients in group A. In three cases a liquid embolic agent (Squid-18) was also injected to obtain complete embolization. No complications were observed after TAE. Successful surgery was performed after a mean time interval of 2.2 days from TAE without any case of conversion to laparotomy. Statistically significant differences between group A and group B were found in intraoperative blood loss (250 ± 200 vs. 400 ± 300 mL, p = 0.039), operative time (245 ± 60 vs. 420 ± 60 min, p = 0.027), and length of stay (5 ± 1 vs. 8 ± 2 days, p = 0.046). Our data suggest that two-step TAE + LLR might be a safe and effective option for surgical treatment of GH >10 cm.

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Impact of tumor proximity to vessel on conversion in laparoscopic liver resection: A retrospective cohort study

Sakamoto,

Ogawa,

Shine

et al. 2024

J Hepato Biliary Pancreat

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BackgroundAlthough various difficulty scoring systems have been proposed for laparoscopic liver resection (LLR), details remain uncertain regarding distance between the tumor and vessels as a factor of difficulty. We aimed to examine the risk factors for conversion to open hepatectomy in LLR, including distance between tumor and vessels.MethodsBetween January 2012 and December 2022, 118 patients who underwent LLR were retrospectively enrolled and their perioperative characteristics were evaluated.ResultsA total of 10 cases (8.5%) were converted to open hepatectomy during LLR. The conversion group had lower platelet count, shorter distance between the tumor and a medium vessel (defined as diameter of 5–10 mm), and greater tumor depth compared with the pure LLR group. Receiver‐operating characteristic curve analysis identified 10 mm as the optimal cutoff value of tumor proximity to a medium vessel (sensitivity, 80.0%, specificity, 78.7%, AUC 0.817) for predicting conversion. In multivariate analysis, lower platelet count (p = .028) and tumor proximity within 10 mm to a medium vessel (p = .001) were independent risk factors for conversion in LLR.ConclusionsOur study suggests tumor proximity within 10 mm to a medium vessel and lower platelet count as predictors of unfavorable intraoperative conversion in LLR.

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Pure laparoscopic right hepatectomy: A risk score for conversion for the paradigm of difficult laparoscopic liver resections. A single centre case series

Cited by 13 publications

References 42 publications

Systematic review and meta‐analysis of difficulty scoring systems for laparoscopic and robotic liver resections

Systematic review and meta‐analysis of difficulty scoring systems for laparoscopic and robotic liver resections

The Two-Step Treatment for Giant Hepatic Hemangiomas

Impact of tumor proximity to vessel on conversion in laparoscopic liver resection: A retrospective cohort study

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