Evolution of laparoscopic liver surgery: 20-year experience of a Norwegian high-volume referral center
Abstract Background Laparoscopic liver surgery has evolved to become a standard surgical approach in many specialized centers worldwide. In this study we present the evolution of laparoscopic liver surgery at a single high-volume referral center since its introduction in 1998. Methods Patients who u...
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| creator | Aghayan, Davit Kazaryan, Airazat Fretland, Åsmund Avdem Røsok, Bård Ingvald Barkhatov, Leonid Lassen, Kristoffer Edwin, Bjørn von Gohren |
| description | Abstract
Background
Laparoscopic liver surgery has evolved to become a standard surgical approach in many specialized centers worldwide. In this study we present the evolution of laparoscopic liver surgery at a single high-volume referral center since its introduction in 1998.
Methods
Patients who underwent laparoscopic liver resection (LLR) between August 1998 and December 2018 at the Oslo University Hospital were analyzed. Perioperative outcomes were compared between three time periods: early (1998 to 2004), middle (2005 to 2012) and recent (2013–2018) .
Results
Up to December 2020, 1533 LLRs have been performed. A total of 1232 procedures were examined (early period, n = 62; middle period, n = 367 and recent period, n = 803). Colorectal liver metastasis was the main indication for surgery (68%). The rates of conversion to laparotomy and hand-assisted laparoscopy were 3.2% and 1.4%. The median operative time and blood loss were 130 min [interquartile range (IQR), 85–190] and 220 ml (IQR, 50–600), respectively. The total postoperative complications rate was 20.3% and the 30-day mortality was 0.3%. The median postoperative stay was two (IQR, 2–4) days.
When comparing perioperative outcomes between the three time periods, shorter operation time (median, from 182 to 120 min, p |
| format | Article |
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Background
Laparoscopic liver surgery has evolved to become a standard surgical approach in many specialized centers worldwide. In this study we present the evolution of laparoscopic liver surgery at a single high-volume referral center since its introduction in 1998.
Methods
Patients who underwent laparoscopic liver resection (LLR) between August 1998 and December 2018 at the Oslo University Hospital were analyzed. Perioperative outcomes were compared between three time periods: early (1998 to 2004), middle (2005 to 2012) and recent (2013–2018) .
Results
Up to December 2020, 1533 LLRs have been performed. A total of 1232 procedures were examined (early period, n = 62; middle period, n = 367 and recent period, n = 803). Colorectal liver metastasis was the main indication for surgery (68%). The rates of conversion to laparotomy and hand-assisted laparoscopy were 3.2% and 1.4%. The median operative time and blood loss were 130 min [interquartile range (IQR), 85–190] and 220 ml (IQR, 50–600), respectively. The total postoperative complications rate was 20.3% and the 30-day mortality was 0.3%. The median postoperative stay was two (IQR, 2–4) days.
When comparing perioperative outcomes between the three time periods, shorter operation time (median, from 182 to 120 min, p < 0.001), less blood loss (median, from 550 to 200 ml, p = 0.023), decreased rate of conversions to laparotomy (from 8 to 3%) and shorter postoperative hospital stay (median, from 3 to 2 days, p < 0.001) was observed in the later periods, while the number of more complex liver resections had increased.
Conclusion
During the last two decades, the indications, the number of patients and the complexity of laparoscopic liver procedures have expanded significantly. Initially being an experimental approach, laparoscopic liver surgery is now safely implemented across our unit and has become the method of choice for surgical treatment of most liver tumors.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><language>nor</language><ispartof>Surgical endoscopy, 2021</ispartof><rights>info:eu-repo/semantics/openAccess</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,4024,26567</link.rule.ids></links><search><creatorcontrib>Aghayan, Davit</creatorcontrib><creatorcontrib>Kazaryan, Airazat</creatorcontrib><creatorcontrib>Fretland, Åsmund Avdem</creatorcontrib><creatorcontrib>Røsok, Bård Ingvald</creatorcontrib><creatorcontrib>Barkhatov, Leonid</creatorcontrib><creatorcontrib>Lassen, Kristoffer</creatorcontrib><creatorcontrib>Edwin, Bjørn von Gohren</creatorcontrib><title>Evolution of laparoscopic liver surgery: 20-year experience of a Norwegian high-volume referral center</title><title>Surgical endoscopy</title><description>Abstract
Background
Laparoscopic liver surgery has evolved to become a standard surgical approach in many specialized centers worldwide. In this study we present the evolution of laparoscopic liver surgery at a single high-volume referral center since its introduction in 1998.
Methods
Patients who underwent laparoscopic liver resection (LLR) between August 1998 and December 2018 at the Oslo University Hospital were analyzed. Perioperative outcomes were compared between three time periods: early (1998 to 2004), middle (2005 to 2012) and recent (2013–2018) .
Results
Up to December 2020, 1533 LLRs have been performed. A total of 1232 procedures were examined (early period, n = 62; middle period, n = 367 and recent period, n = 803). Colorectal liver metastasis was the main indication for surgery (68%). The rates of conversion to laparotomy and hand-assisted laparoscopy were 3.2% and 1.4%. The median operative time and blood loss were 130 min [interquartile range (IQR), 85–190] and 220 ml (IQR, 50–600), respectively. The total postoperative complications rate was 20.3% and the 30-day mortality was 0.3%. The median postoperative stay was two (IQR, 2–4) days.
When comparing perioperative outcomes between the three time periods, shorter operation time (median, from 182 to 120 min, p < 0.001), less blood loss (median, from 550 to 200 ml, p = 0.023), decreased rate of conversions to laparotomy (from 8 to 3%) and shorter postoperative hospital stay (median, from 3 to 2 days, p < 0.001) was observed in the later periods, while the number of more complex liver resections had increased.
Conclusion
During the last two decades, the indications, the number of patients and the complexity of laparoscopic liver procedures have expanded significantly. Initially being an experimental approach, laparoscopic liver surgery is now safely implemented across our unit and has become the method of choice for surgical treatment of most liver tumors.</description><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>3HK</sourceid><recordid>eNqFjEsKwjAUAIMoWD9n8F0gkKYpTd2K4sqV-xLCaxuJSXlp_dxeBPeuZjMzM5blqpBcylzPWSbqQnBZ1WrJVindhBCqzsuMtcdH9NPoYoDYgjeDoZhsHJwF7x5IkCbqkN57kIK_0RDga0ByGCx-CwOXSE_snAnQu67n390dgbBFIuPBYhiRNmzRGp9w--Oa7U7H6-HMLbk0utCESKbJhS5lo3WldPHf-ACEK0TB</recordid><startdate>2021</startdate><enddate>2021</enddate><creator>Aghayan, Davit</creator><creator>Kazaryan, Airazat</creator><creator>Fretland, Åsmund Avdem</creator><creator>Røsok, Bård Ingvald</creator><creator>Barkhatov, Leonid</creator><creator>Lassen, Kristoffer</creator><creator>Edwin, Bjørn von Gohren</creator><scope>3HK</scope></search><sort><creationdate>2021</creationdate><title>Evolution of laparoscopic liver surgery: 20-year experience of a Norwegian high-volume referral center</title><author>Aghayan, Davit ; Kazaryan, Airazat ; Fretland, Åsmund Avdem ; Røsok, Bård Ingvald ; Barkhatov, Leonid ; Lassen, Kristoffer ; Edwin, Bjørn von Gohren</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-cristin_nora_10852_887483</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>nor</language><creationdate>2021</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Aghayan, Davit</creatorcontrib><creatorcontrib>Kazaryan, Airazat</creatorcontrib><creatorcontrib>Fretland, Åsmund Avdem</creatorcontrib><creatorcontrib>Røsok, Bård Ingvald</creatorcontrib><creatorcontrib>Barkhatov, Leonid</creatorcontrib><creatorcontrib>Lassen, Kristoffer</creatorcontrib><creatorcontrib>Edwin, Bjørn von Gohren</creatorcontrib><collection>NORA - Norwegian Open Research Archives</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Aghayan, Davit</au><au>Kazaryan, Airazat</au><au>Fretland, Åsmund Avdem</au><au>Røsok, Bård Ingvald</au><au>Barkhatov, Leonid</au><au>Lassen, Kristoffer</au><au>Edwin, Bjørn von Gohren</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evolution of laparoscopic liver surgery: 20-year experience of a Norwegian high-volume referral center</atitle><jtitle>Surgical endoscopy</jtitle><date>2021</date><risdate>2021</risdate><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Abstract
Background
Laparoscopic liver surgery has evolved to become a standard surgical approach in many specialized centers worldwide. In this study we present the evolution of laparoscopic liver surgery at a single high-volume referral center since its introduction in 1998.
Methods
Patients who underwent laparoscopic liver resection (LLR) between August 1998 and December 2018 at the Oslo University Hospital were analyzed. Perioperative outcomes were compared between three time periods: early (1998 to 2004), middle (2005 to 2012) and recent (2013–2018) .
Results
Up to December 2020, 1533 LLRs have been performed. A total of 1232 procedures were examined (early period, n = 62; middle period, n = 367 and recent period, n = 803). Colorectal liver metastasis was the main indication for surgery (68%). The rates of conversion to laparotomy and hand-assisted laparoscopy were 3.2% and 1.4%. The median operative time and blood loss were 130 min [interquartile range (IQR), 85–190] and 220 ml (IQR, 50–600), respectively. The total postoperative complications rate was 20.3% and the 30-day mortality was 0.3%. The median postoperative stay was two (IQR, 2–4) days.
When comparing perioperative outcomes between the three time periods, shorter operation time (median, from 182 to 120 min, p < 0.001), less blood loss (median, from 550 to 200 ml, p = 0.023), decreased rate of conversions to laparotomy (from 8 to 3%) and shorter postoperative hospital stay (median, from 3 to 2 days, p < 0.001) was observed in the later periods, while the number of more complex liver resections had increased.
Conclusion
During the last two decades, the indications, the number of patients and the complexity of laparoscopic liver procedures have expanded significantly. Initially being an experimental approach, laparoscopic liver surgery is now safely implemented across our unit and has become the method of choice for surgical treatment of most liver tumors.</abstract><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0930-2794 |
| ispartof | Surgical endoscopy, 2021 |
| issn | 0930-2794 1432-2218 |
| language | nor |
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| source | NORA - Norwegian Open Research Archives; SpringerNature Journals |
| title | Evolution of laparoscopic liver surgery: 20-year experience of a Norwegian high-volume referral center |
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