Top

Published in:

01-11-2017 | Original Scientific Report

Short-Term Outcomes of Totally Laparoscopic Central Hepatectomy and Right Anterior Sectionectomy for Centrally Located Tumors: A Case-Matched Study with Propensity Score Matching

Published in: World Journal of Surgery | Issue 11/2017

Abstract

Background

Recent advances in technology and accumulation of surgical experience have expanded the indications for laparoscopic liver resection (LLR). However, compared to open liver resection (OLR), the feasibility of laparoscopic anatomical liver resection for centrally located tumor (CLT) has not been clearly established. The aim of our study was to assess the feasibility and safety of laparoscopic anatomical major liver resection for CLT.

Methods

From April 2011 to March 2016, 20 cases of anatomical LLR and 86 cases of OLR for CLTs such as central hepatectomy (CH) and right anterior sectionectomy (RAS) were performed at a single institution. We performed one-to-one propensity score matching and analyzed short-term outcomes between the LLR (n = 20) and OLR (n = 20) groups.

Results

Among 20 cases in the LLR group, two cases underwent open conversion due to common bile duct injury and anatomical distortion, respectively. There were no statistically significant difference between the LLR and OLR groups regarding clamping time of the Pringle maneuver (p = 0.502), blood loss (p = 0.746), surgical margin (p = 0.198), or length of hospital stay (p = 0.110). However, surgical time was significantly longer in the LLR group than in the OLR group (388 vs 268 min; p < 0.001). There were no significant differences between the two groups with regard to morbidity rate or mean comprehensive complication index (p = 0.716 and p = 0.819, respectively).

Conclusion

Total anatomical LLR can be performed safely in selected CLT patients by experienced surgeons. Laparoscopic CH or RAS appears feasible with non-inferior perioperative outcomes compared to OLR.

Gagner M, Rheault M, Dubuc J (1992) Laparoscopic partial hepatectomy for liver tumor. Surg Endosc 6:97–98

Buell JF, Cherqui D, Geller DA et al (2009) The international position on laparoscopic liver surgery: the Louisville Statement, 2008. Ann Surg 250:825–830CrossRefPubMed

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 261:619–629PubMed

Lee GC, Kwon CHD, Joh JW et al (2011) Preliminary experience of laparoscopic hepatectomy for hepatocellular carcinoma. Korean J Hepatobiliary Pancreat Surg 15:7–12

Parks KR, Kuo YH, Davis JM et al (2014) Laparoscopic versus open liver resection: a meta-analysis of long-term outcome. HPB (Oxford) 16:109–118CrossRef

Ho CM, Wakabayashi G, Nitta H et al (2013) Total laparoscopic limited anatomical resection for centrally located hepatocellular carcinoma in cirrhotic liver. Surg Endosc 27:1820–1825CrossRefPubMed

Machado MA, Kalil AN (2011) Glissonian approach for laparoscopic mesohepatectomy. Surg Endosc 25:2020–2022CrossRefPubMed

Kim YK, Han HS, Yoon YS et al (2015) Total anatomical laparoscopic liver resection of segment 4 (s4), extended s4, and subsegments s4a and s4b for hepatocellular carcinoma. J Laparoendosc Adv Surg Tech A 25:375–379CrossRefPubMed

Yoon YS, Han HS, Cho JY et al (2009) Totally laparoscopic central bisectionectomy for hepatocellular carcinoma. J Laparoendosc Adv Surg Tech A 19:653–656CrossRefPubMed

10.

Wolters U, Wolf T, Stutzer H et al (1996) ASA classification and perioperative variables as predictors of postoperative outcome. Br J Anaesth 77:217–222CrossRefPubMed

11.

Takasaki K (1998) Glissonean pedicle transection method for hepatic resection: a new concept of liver segmentation. J Hepatobiliary Pancreat Surg 5:286–291CrossRefPubMed

12.

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 92:383–386. doi:10.4174/astr.2017.92.5.383 CrossRefPubMedPubMedCentral

13.

Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213CrossRefPubMedPubMedCentral

14.

Han HS, Shehta A, Ahn S et al (2015) Laparoscopic versus open liver resection for hepatocellular carcinoma: case-matched study with propensity score matching. J Hepatol 63:643–650CrossRefPubMed

15.

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

16.

Ban D, Kudo A, Ito H et al (2015) The difficulty of laparoscopic liver resection. Updates Surg 67:123–128CrossRefPubMed

17.

Sartori S, Tombesi P, Macario F et al (2008) Subcapsular liver tumors treated with percutaneous radiofrequency ablation: a prospective comparison with nonsubcapsular liver tumors for safety and effectiveness. Radiology 248:670–679CrossRefPubMed

18.

Yoon YS, Han HS, Cho JY et al (2013) Laparoscopic liver resection for centrally located tumors close to the hilum, major hepatic veins, or inferior vena cava. Surgery 153:502–509CrossRefPubMed

19.

Lesurtel M, Cherqui D, Laurent A et al (2003) Laparoscopic versus open left lateral hepatic lobectomy: a case-control study. J Am Coll Surg 196:236–242CrossRefPubMed

20.

Chang S, Laurent A, Tayar C et al (2007) Laparoscopy as a routine approach for left lateral sectionectomy. Br J Surg 94:58–63CrossRefPubMed

21.

Ahn KS, Kang KJ, Kim YH et al (2014) A propensity score-matched case-control comparative study of laparoscopic and open liver resection for hepatocellular carcinoma. J Laparoendosc Adv Surg Tech A 24:872–877CrossRefPubMed

22.

Ciria R, Cherqui D, Geller DA et al (2016) Comparative short-term benefits of laparoscopic liver resection: 9000 cases and climbing. Ann Surg 263:761–777CrossRefPubMed

23.

Ban D, Tanabe M, Ito H et al (2014) A novel difficulty scoring system for laparoscopic liver resection. J Hepatobiliary Pancreat Sci 21:745–753CrossRefPubMed

Title: Short-Term Outcomes of Totally Laparoscopic Central Hepatectomy and Right Anterior Sectionectomy for Centrally Located Tumors: A Case-Matched Study with Propensity Score Matching
Publication date: 01-11-2017
Published in: World Journal of Surgery / Issue 11/2017
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-017-4105-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Short-Term Outcomes of Totally Laparoscopic Central Hepatectomy and Right Anterior Sectionectomy for Centrally Located Tumors: A Case-Matched Study with Propensity Score Matching

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 11/2017

Outcomes of Kidney Donors over 60 Years Old: A Single-Center Cohort Study

A Novel, Dynamic Statistical Model for Predicting Patient Satisfaction with Fundoplication Based on Pre-Operative Symptom Patterns

Quality of Recovery After Low-Pressure Laparoscopic Donor Nephrectomy Facilitated by Deep Neuromuscular Blockade: A Randomized Controlled Study

Undiagnosed Liver Fibrosis in Patients Undergoing Pancreatoduodenectomy for Pancreatic Adenocarcinoma

Primary Recurrence in the Lung is Related to Favorable Prognosis in Patients with Pancreatic Cancer and Postoperative Recurrence

The Advent of Ultra-high Volume Thoracic Surgical Centers in Shanghai