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01-03-2020 | Metastasis | Original Article

A multicenter cohort analysis of laparoscopic hepatic caudate lobe resection

Authors: M. Cappelle, D. L. Aghayan, M. J. van der Poel, M. G. Besselink, G. Sergeant, B. Edwin, I. Parmentier, C. De Meyere, F. Vansteenkiste, M. D’Hondt

Published in: Langenbeck's Archives of Surgery | Issue 2/2020

Abstract

Introduction

Laparoscopic resection of the hepatic caudate lobe (LRCL) requires a high level of expertise due to its challenging anatomical area. Only case reports, case series, and single-center cohort studies have been published. The aim of this study was to assess the safety and feasibility of this laparoscopic procedure.

Methods

A multicenter retrospective cohort study including all patients who underwent LRCL in 4 high-volume hepatobiliary units between January 2000 and May 2018 was performed. Perioperative, postoperative, and survival outcomes were assessed. Postoperative morbidity was stratified according to the Clavien-Dindo classification with severe complications defined by grade III or more. The Kaplan-Meier method was used for survival analysis.

Results

A total of 32 patients were included, including 22 (68.8%) with colorectal liver metastasis (CRLM), one (3.1%) with cholangiocarcinoma, four (12.5%) with other malignancies, and five (15.6%) with symptomatic benign lesions. Simultaneous colorectal and/or additional liver resection was performed in 20 (62.5%) patients. The median (IQR) operative time was 155 (121–280) minutes, blood loss was 100 (50–275) ml, conversion rate was 9.4% (n = 3), severe complications were observed in 2 patients (6.3%), and median (range) length of hospital stay was 3 [1–39] days. No 90-day postoperative mortality was noticed. The median (IQR) follow-up for the CRLM group was 14 [10–23] months. Five-year overall survival rate was 82% in this subgroup. Small interinstitutional differences were observed without major impact on surgical outcomes.

Conclusion

LRCL is safe and feasible when performed in high-volume centers. Profound anatomical knowledge, advanced laparoscopic skills, and mastering intraoperative ultrasound are essential. No major interinstitutional differences were ascertained.

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Title: A multicenter cohort analysis of laparoscopic hepatic caudate lobe resection
Authors: M. Cappelle
D. L. Aghayan
M. J. van der Poel
M. G. Besselink
G. Sergeant
B. Edwin
I. Parmentier
C. De Meyere
F. Vansteenkiste
M. D’Hondt
Publication date: 01-03-2020
Publisher: Springer Berlin Heidelberg
Keywords: Metastasis
Liver Resection
Liver Resection
Cholangiocarcinoma
Cholangiocarcinoma
Published in: Langenbeck's Archives of Surgery / Issue 2/2020
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-020-01867-2

At a glance: The STEP trials

Springer Medicine

A multicenter cohort analysis of laparoscopic hepatic caudate lobe resection

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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