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01-03-2019 | Ultrasound | Original Article

Ultrasound liver map technique for laparoscopic liver resections: perioperative outcomes are not impaired by technical complexity

Authors: Alessandro Ferrero, Nadia Russolillo, Serena Langella, Fabio Forchino, Matteo Stasi, Federico Fazio, Roberto Lo Tesoriere

Published in: Updates in Surgery | Issue 1/2019

Abstract

Intraoperative liver ultrasound has a crucial role to guide open liver surgery. A 4-step ultrasound liver map technique for laparoscopic liver resection (LLR) has been standardized in our center. The aim of this study was to evaluate outcomes of our technique according to the hepatectomy technical complexity. A difficulty scale (DS) ranging from 1 to 10 was applied to each LLR. A cumulative sum control-chart analysis identified 3 periods of gradually increasing DS. Perioperative outcomes of the 3 periods were compared. 300 LLRs performed between 2006 and 2018 were analyzed. Median DS was 3 for first 100 cases (P1), 5 for cases 101–200 (P2) and 6 for cases 201–300 (P3). A significantly greater percentage of postero-superior segments resections (P1 11%, P2 36%, P3 46%, p < 0.001) were performed in P3. P3 LLRs had a significantly longer transection time (p < 0.001) and wider cut surface area (p < 0.001), but median blood losses were similar among the 3 periods (P1 100 cc, P2 100 cc, P3 140 cc). There were no differences among periods in overall morbidity (P1 12%, P2 17%, P3 17%), major morbidity (P1 1%, P2 2%, P3 3%) and length of hospital stay (5 days in all the three groups). Despite the increasing surgical complexity of LLR, ultrasound liver map technique allows good perioperative outcomes.

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Buell JF, Cherqui D, Geller DA, O’Rourke N, Iannitti D, Dagher I, Koffron AJ, Thomas M, Gayet B, Han HS, Wakabayashi G, Belli G, Kaneko H, Ker C-G, Scatton O, Laurent A, Abdalla EK, Chaudhury P, Dutson E, Gamblin C, D’Angelica M, Nagorney D, Testa G, Labow D, Manas D, Poon RT, Nelson H, Martin R, Clary B, Pinson WC, Martinie J, Vauthey J-N, Goldstein R, Roayaie S, Barlet D, Espat J, Abecassis M, Rees M, Fong Y, McMasters KM, Broelsch C, Busuttil R, Belghiti J, Strasberg S, Chari RS (2009) The international position on laparoscopic liver surgery. Ann Surg 250:825–830CrossRefPubMed

Wakabayashi G, Cherqui D, Geller DA, Buell JF, Kaneko H, Han HS, Asbun H, O’Rourke N, Tanabe M, Koffron AJ, Tsung A, Soubrane O, Machado MA, Gayet B, Troisi RI, Pessaux P, Van Dam RM, Scatton O, Abu Hilal M, Belli G, Kwon CH, Edwin B, Choi GH, Aldrighetti LA, Cai X, Cleary S, Chen KH, Schon MR, Sugioka A, Tang CN, Herman P, Pekolj J, Chen XP, Dagher I, Jarnagin W, Yamamoto M, Strong R, Jagannath P, Lo CM, Clavien PA, Kokudo N, Barkun J, Strasberg SM (2015) Recommendations for laparoscopic liver resection: a report from the second international consensus conference held in Morioka. Ann Surg 261:619–629PubMed

Nguyen KT, Gamblin TC, Geller DA (2009) World review of laparoscopic liver resection—2804 patients. Ann Surg 250:831–884CrossRefPubMed

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

Aldrighetti L, Ratti F, Cillo U, Ferrero A, Ettorre GM, Guglielmi A, Giuliante F, Calise F, Italian Group of Minimally Invasive Liver Surgery (I GO MILS) (2017) Diffusion, outcomes and implementation of minimally invasive liver surgery: a snapshot from the I Go MILS (Italian Group of Minimally Invasive Liver Surgery) Registry. Updates Surg. 69:271–283CrossRefPubMed

Langella S, Russolillo N, D’Eletto M, Forchino F, Lo Tesoriere R, Ferrero A (2015) Oncological safety of ultrasound-guided laparoscopic liver resection for colorectal metastases: a case-control study. Updates Surg 67:147–155CrossRefPubMed

Fretland ÅA, Dagenborg VJ, Bjørnelv GMW, Kazaryan AM, Kristiansen R, Fagerland MW, Hausken J, Tønnessen TI, Abildgaard A, Barkhatov L, Yaqub S, Røsok BI, Bjørnbeth BA, Andersen MH, Flatmark K, Aas E, Edwin B (2018) Laparoscopic versus open resection for colorectal liver metastases: the OSLO-COMET randomized controlled trial. Ann Surg 267(2):199–207CrossRefPubMed

Fukuda M, Hirata K, Mima S (1992) Preliminary evaluation of sonolaparoscopy in the diagnosis of liver diseases. Endoscopy 24:701–708CrossRefPubMed

Viganò L, Ferrero A, Amisano M, Russolillo N, Capussotti L (2013) Comparison of laparoscopic and open intraoperative ultrasonography for staging liver tumours. Br J Surg 100:535–542CrossRefPubMed

10.

Tomassini F, Scuderi V, Colman R, Vivarelli M, Montalti R, Troisi RI (2016) The single surgeon learning curve of laparoscopic liver resection: a continuous evolving process through stepwise difficulties. Medicine (Baltimore) 95:e5138CrossRef

11.

Yap CH, Colson ME, Watters DA (2007) Cumulative sum techniques for surgeons: a brief review. ANZ J Surg 77:583–586CrossRefPubMed

12.

Belghiti J, Clavien PA, Gadzijev E, Garden JO, Lau WY, Makuuchi M, Strong RW (2000) The Brisbane 2000 terminology of liver anatomy and resections. Terminology committee of the international hepato-pancreato-biliary association. HPB 2(3):333–339CrossRef

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.

Slankamenac K, Nederlof N, Pessaux P, de Jonge J, Wijnhoven BP, Breitenstein S (2014) The comprehensive complication index: a novel and more sensitive endpoint for assessing outcome and reducing sample size in randomized controlled trials. Ann Surg 260:757–762CrossRefPubMed

15.

Våpenstad C, Rethy A, Langø T, Selbekk T, Ystgaard B, Hernes TA, Mårvik R (2010) Laparoscopic ultrasound: a survey of its current and future use, requirements, and integration with navigation technology. Surg Endosc 24(12):2944–2953CrossRefPubMed

16.

Abu Hilal M, Aldrighetti L, Dagher I, Edwin B, Troisi RI, Alikhanov R, Aroori S, Belli G, Besselink M, Briceno J, Gayet B, D’Hondt M, Lesurtel M, Menon K, Lodge P, Rotellar F, Santoyo J, Scatton O, Soubrane O, Sutcliffe R, Van Dam R, White S, Halls MC, Cipriani F, Van der Poel M, Ciria R, Barkhatov L, Gomez-Luque Y, Ocana-Garcia S, Cook A, Buell J, Clavien PA, Dervenis C, Fusai G, Geller D, Lang H, Primrose J, Taylor M, Van Gulik T, Wakabayashi G, Asbun H, Cherqui D (2018) The Southampton consensus guidelines for laparoscopic liver surgery: from indication to implementation. Ann Surg 268(1):11–18CrossRefPubMed

17.

Hallet J, Pessaux P, Beyfuss KA, Jayaraman S, Serrano PE, Martel G, Coburn NG, Piardi T, Mahar AL (2019) Critical appraisal of predictive tools to assess the difficulty of laparoscopic liver resection: a systematic review. Surg Endosc 33:366–376CrossRefPubMed

18.

Vigano L, Laurent A, Tayar C, Tomatis M, Ponti A, Cherqui D (2009) The learning curve in laparoscopic liver resection: improved feasibility and reproducibility. Ann Surg 250:772–782CrossRefPubMed

19.

Kluger MD, Vigano L, Barroso R, Cherqui D (2013) The learning curve in laparoscopic major liver resection. J Hepatobiliary Pancreat Sci 20:131–136CrossRefPubMed

20.

Ratti F, Barkhatov LI, Tomassini F, Cipriani F, Kazaryan AM, Edwin B, Abu Hilal M, Troisi RI, Aldrighetti L (2016) Learning curve of self-taught laparoscopic liver surgeons in left lateral sectionectomy: results from an international multi-institutional analysis on 245 cases. Surg Endosc 30:3618–3629CrossRefPubMed

21.

Brown KM, Geller DA (2016) What is the Learning Curve for Laparoscopic Major Hepatectomy? J Gastrointest Surg 20:1065–1071CrossRefPubMed

22.

Ratti F, Cipriani F, Catena M, Paganelli M, Aldrighetti L (2017) Approach to hepatocaval confluence during laparoscopic right hepatectomy: three variations on a theme. Surg Endosc 31:949CrossRefPubMed

23.

Vibert E, Perniceni T, Levard H, Denet C, Shahri NK, Gayet B (2006) Laparoscopic liver resection. Br J Surg 93:67–72CrossRefPubMed

24.

Nguyen KT, Marsh JW, Tsung A, Steel JJ, Gamblin TC, Geller DA (2011) Comparative benefits of laparoscopic vs open hepatic resection: a critical appraisal. Arch Surg 146:348–356CrossRefPubMed

25.

Cauchy F, Fuks D, Nomi T, Schwarz L, Barbier L, Dokmak S, Scatton O, Belghiti J, Soubrane O, Gayet B (2015) Risk factors and consequences of conversion in laparoscopic major liver resection. Br J Surg 102:785–795CrossRefPubMed

26.

Ferrero L, Vigano R, Polastri D, Ribero R Lo, Tesoriere A, Muratore L Capussotti (2005) Hepatectomy as treatment of choice for hepatocellular carcinoma in elderly cirrhotic patients. World J Surg 29:1101–1105CrossRefPubMed

27.

Takahashi Y, Ebata T, Yokoyama Y, Igami T, Sugawara G, Nagino M (2013) Surgical treatment of perihilar cholangiocarcinoma in octogenarians: a single center experience. J Hepato-Biliary-Pancreat Sci 20:324–331CrossRef

28.

Shirabe K, Kajiyama K, Harimoto N, Gion T, Tsujita E, Abe T, Wakiyama S, Nagaie T, Maehara Y (2009) Early outcome following hepatic resection in patients older than 80 years of age, World. J Surg 33:1927–1932

29.

Adam R, Frilling A, Elias D, Laurent C, Ramos E, Capussotti L (2010) Liver resection of colorectal metastases in elderly patients. Br J Surg 97:366–376CrossRefPubMed

Title: Ultrasound liver map technique for laparoscopic liver resections: perioperative outcomes are not impaired by technical complexity
Authors: Alessandro Ferrero
Nadia Russolillo
Serena Langella
Fabio Forchino
Matteo Stasi
Federico Fazio
Roberto Lo Tesoriere
Publication date: 01-03-2019
Publisher: Springer International Publishing
Keywords: Ultrasound
Liver Surgery
Liver Resection
Liver Surgery
Liver Resection
Ultrasound
Published in: Updates in Surgery / Issue 1/2019
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI: https://doi.org/10.1007/s13304-019-00646-z

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Ultrasound liver map technique for laparoscopic liver resections: perioperative outcomes are not impaired by technical complexity

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