Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Surgical Endoscopy
Published in: Surgical Endoscopy 4/2019

01-04-2019

Outcomes of pure laparoscopic Glissonian pedicle approach hepatectomy for hepatocellular carcinoma: a propensity score matching analysis

Authors: Fei Liu, Hongwei Xu, Qin Li, Yonggang Wei, Hongyu Li, Wentao Wang, Tianfu Wen, Hong Wu, Jiayin Yang, Mingqing Xu, Bo Li

Published in: Surgical Endoscopy | Issue 4/2019

Login to get access

Abstract

Background

Few studies had been performed to concern the outcomes of pure laparoscopic Glissonian pedicle approach hepatectomy (LGAH) for hepatocellular carcinoma (HCC). The aim of this study was to compare the outcomes of LGAH versus open Glissonian pedicle approach hepatectomy (OGAH) for HCC, especially in patients with cirrhosis.

Methods

Hepatocellular carcinoma patients who underwent pure LGAH and OGAH between January 2015 and July 2017 in our institution were retrospectively enrolled in this study. Propensity score matching (PSM) of patients in a ratio of 1:1 was conducted to adjust the known confounders. The perioperative and oncological outcomes were compared between the two groups after PSM.

Results

Some 80 patients underwent pure LGAH and 134 had OGAH. After PSM, 67 patients in each group were well matched for analysis. Both the postoperative overall complication rates (13.4% vs. 29.9%, P = 0.021) and mean comprehensive complication index (2.63 vs. 7.40, P = 0.035) were significantly lower in the LGAH group than those in OGAH group. Although the operative time was longer in the LRH group (P < 0.001), the length of postoperative hospital stay was shorter in the LRH group (P = 0.024). Furthermore, both the 3-year overall survival rate (73.3% for LGAH vs. 77.8% for OGAH, P = 0.338) and 3-year disease-free survival rate (56.4% for LGAH vs. 62.5% for OGAH, P = 0.455) were not significantly different between the groups.

Conclusion

Pure laparoscopic Glissonian approach may be a better alternative to open Glissonian approach in selected HCC patients, which provided fewer complications, shorter postoperative hospital stay and comparable oncological outcomes.
Literature
1.
Ciria R, Cherqui D, Geller DA, Briceno J, Wakabayashi G (2016) Comparative short-term benefits of laparoscopic liver resection: 9000 cases and climbing. Ann Surg 263:761–777CrossRefPubMed
2.
Lefor AT, Flowers JL (1994) Laparoscopic wedge biopsy of the liver. J Am Coll Surg 178:307–308PubMed
3.
Dulucq JL, Wintringer P, Stabilini C, Berticelli J, Mahajna A (2005) Laparoscopic liver resections: a single center experience. Surg Endosc 19:886–891CrossRefPubMed
4.
Soubrane O, Cherqui D, Scatton O et al (2006) Laparoscopic left lateral sectionectomy in living donors: safety and reproducibility of the technique in a single center. Ann Surg 244:815–820CrossRefPubMedPubMedCentral
5.
Kim KH, Kang SH, Jung DH et al (2017) Initial outcomes of pure laparoscopic living donor right hepatectomy in an experienced adult living donor liver transplant center. Transplantation 101:1106–1110CrossRefPubMed
6.
Brown KM, Geller DA (2016) What is the learning curve for laparoscopic major hepatectomy? J Gastrointest Surg 20:1065–1071CrossRefPubMed
7.
Huanwei C, Feiwen D (2016) Pure laparoscopic right hemihepatectomy via anterior approach. Surg Endosc 30(12):5621CrossRefPubMed
8.
9.
Zhang Y, Yang H, Deng X et al (2016) Intermittent Pringle maneuver versus continuous hemihepatic vascular inflow occlusion using extra-glissonian approach in laparoscopic liver resection. Surg Endosc 30(3):961–970CrossRefPubMed
10.
Machado MA, Surjan RC, Basseres T et al (2016) The laparoscopic Glissonian approach is safe and efficient when compared with standard laparoscopic liver resection: results of an observational study over 7. years. Surgery 160(3):643–651CrossRefPubMed
11.
Lortat-Jacob JL, Robert HG, Henry C (1952) Case of right segmental hepatectomy. Memoires Academie de chirurgie 78(8–9):244–251
12.
Launois B, Jamieson GG (1992) The posterior intrahepatic approach for hepatectomy or removal of segments of the liver. Surg Gynecol Obstet 174:155–158PubMed
13.
Takasaki K, Kobayashi S, Tanaka S et al (1990) Highly anatomically systematized hepatic resection with Glissonean sheath code transection at the hepatic hilus. Int Surg 75:73–77PubMed
14.
Galperin EI, Karagiulian SR (1989) A new simplified method of selective exposure of hepatic pedicles for controlled hepatectomies. HPB Surg 1:119–130CrossRefPubMedPubMedCentral
15.
Takasari K (1998) Glissonean pedicle transection method for hepatic resection:a new concept o liver segmentation. J Hepatobiliary Pancreat Surg 5:286–291CrossRef
16.
Ramaciato G, Aurello P, D’Angelo F et al (1998) Effective vascular endostapler techniques in hepatic resection. Int Surg 83:317–323
17.
Figueras J, Lopez-Ben S, Lladó L et al (2003) Hilar dissection versus the “glissonean” approach and stapling of the pedicle for major hepatectomies: a prospective, randomized trial. Ann Surg 238:111–119PubMedPubMedCentral
18.
Tsuruta K, Okamoto A, Toi M et al (2002) Impact of selective Glisson transection on survival of hepatocellular carcinoma. Hepatogastroenterology 49:1607–1610PubMed
19.
Machado MA, Makdissi FF, Galvao FH, Machado MC (2008) Intrahepatic Glissonian approach for laparoscopic right segmental liver resections. Am J Surg 196(4):e38 –42CrossRefPubMed
20.
Machado MA, Kalil AN (2011) Glissonian approach for laparoscopic mesohepatectomy. Surg Endosc 25(6):2020–2022CrossRefPubMed
21.
Cho A, Yamamoto H, Kainuma O et al (2011) Safe and feasible extrahepatic Glissonean access in laparoscopic anatomical liver resection. Surg Endosc 25(4):1333–1336CrossRefPubMed
22.
Liu F, Zhang J, Lei C, Wei Y, Li B (2016) Feasibility of laparoscopic major hepatectomy for hepatic paragonimiasis: two case reports. Medicine (Baltimore) 95(38):e4939CrossRef
23.
24.
Lee N, Cho CW, Kim JM et al (2017) Application of temporary inflow control of the Glissonean pedicle method provides a safe and easy technique for totally laparoscopic hemihepatectomy by Glissonean approach. Ann Surg Treat Res 92(5):383–386CrossRefPubMedPubMedCentral
25.
Tranchart H, O’Rourke N, Van Dam R et al (2015) Bleeding control during laparoscopic liver resection: a review of literature. J Hepatobiliary Pancreat Sci 22:371–378CrossRefPubMed
26.
Pang YY (2002) The Brisbane 2000 terminology of liver anatomy and resections. HPB 2:333–339
27.
Clavien PA, Barkun J, de Oliveira ML et al (2009) The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 250:187–196CrossRefPubMed
28.
Slankamenac K, Graf R, Barkun J, Puhan MA, Clavien PA (2013) The comprehensive complication index: a novel continuous scale to measure surgical morbidity. Ann Surg 258:1–7CrossRefPubMed
29.
Rahbari NN, Garden OJ, Padbury R et al (2011) Post-hepatectomy haemorrhage: a definition and grading by the International Study Group of Liver Surgery (ISGLS). HPB 13(8):528–535CrossRefPubMedPubMedCentral
30.
Koch M, Garden OJ, Padbury R et al (2011) Bile leakage after hepatobiliary and pancreatic surgery: a definition and grading of severity by the International Study Group of Liver Surgery. Surgery 149:680–688CrossRefPubMed
31.
Figueras J, Llado L, Ruiz D et al (2005) Complete versus selective portal triad clamping for minor liver resections: a prospective randomized trial. Ann Surg 241:582–590CrossRefPubMedPubMedCentral
32.
Rahbari NN, Garden OJ, Padbury R et al (2011) Posthepatectomy liver failure: a definition and grading by the International Study Group of Liver Surgery (ISGLS). Surgery 149:713–724CrossRefPubMed
33.
Guo S, Fraser MW (2010) Propensity score analysis: statistical methods and applications. Advanced quantitative techniques in the social sciences series. SAGE Publications, Inc, Los Angeles
34.
35.
Wakabayashi G, Cherqui D, Geller DA et al (2015) Recommendations for laparoscopic liver resection: a report from the second international consensus conference held in Morioka. Ann Surg. 261(4):619–629
36.
Figueroa R, Laurenzi A, Laurent A, Cherqui D (2018) Perihilar Glissonian approach for anatomical parenchymal sparing liver resections: technical aspects: the taping game. Ann Surg 267(3):537–543CrossRef
37.
Takahara T, Wakabayashi G, Beppu T et al (2015) Long-term and perioperative outcomes of laparoscopic versus open liver resection for hepatocellular carcinoma with propensity score matching: a multi-institutional Japanese study. J Hepatobiliary Pancreat Sci 22:721–727CrossRefPubMed
38.
Sposito C, Battiston C, Facciorusso A et al (2016) Propensity score analysis of outcomes following laparoscopic or open liver resection for hepatocellular carcinoma. Br J Surg 103:871–880CrossRefPubMed
39.
Scuderi V, Barkhatov L, Montalti R et al (2017) Outcome after laparoscopic and open resections of posterosuperior segments of the liver. Br J Surg 104:751–759CrossRefPubMed
40.
Cheung TT, Dai WC, Tsang SH et al (2016) Pure Laparoscopic hepatectomy versus open hepatectomy for hepatocellular carcinoma in 110 patients with liver cirrhosis: a propensity analysis at a single center. Ann Surg 264:612–620CrossRefPubMed
41.
Yoon YI, Kim KH, Kang SH et al (2017) Pure laparoscopic versus open right hepatectomy for hepatocellular carcinoma in patients with cirrhosis: a propensity score matched analysis. Ann Surg 265:856–863CrossRefPubMed
42.
Terasawa M, Ishizawa T, Mise Y et al (2017) Applications of fusion-fluorescence imaging using indocyanine green in laparoscopic hepatectomy. Surg Endosc 31:5111–5118CrossRefPubMed
43.
Xu HW, Liu F, Li HY, Wei YG, Li B (2018) Outcomes following laparoscopic versus open major hepatectomy for hepatocellular carcinoma in patients with cirrhosis: a propensity score- matched analysis. Surg Endosc 32:712–719CrossRefPubMed
44.
Mouly C, Fuks D, Browet F et al (2013) Feasibility of the Glissonian approach during right hepatectomy. HPB (Oxford) 15:638–645CrossRefPubMedCentral
Metadata
Title
Outcomes of pure laparoscopic Glissonian pedicle approach hepatectomy for hepatocellular carcinoma: a propensity score matching analysis
Authors
Fei Liu
Hongwei Xu
Qin Li
Yonggang Wei
Hongyu Li
Wentao Wang
Tianfu Wen
Hong Wu
Jiayin Yang
Mingqing Xu
Bo Li
Publication date
01-04-2019
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 4/2019
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-018-6380-0

Other articles of this Issue 4/2019

Surgical Endoscopy 4/2019 Go to the issue

OriginalPaper

Endoscopic resection of advanced ampullary adenomas: a single-center 14-year retrospective cohort study

OriginalPaper

Comparative efficacy of various anti-ulcer medications after gastric endoscopic submucosal dissection: a systematic review and network meta-analysis

2018 SAGES Oral

Laparoscopic versus open splenectomy for splenomegaly: the verdict is unclear

Endoluminal Surgery

Per oral endoscopic tumor (POET) resection for treatment of upper gastrointestinal subepithelial tumors

OriginalPaper

The effect of distance on short-term outcomes in a regionalized, publicly funded bariatric surgery model

OriginalPaper

Correlation between laparoscopic transection of an indirect inguinal hernial sac and postoperative seroma formation: a prospective randomized controlled study