Laparoscopic Liver Resection: Experience of 436 Cases in One Center
Background To report experience of laparoscopic liver resection (LLR) in one center. Methods We retrospectively reviewed 436 consecutive LLRs in 411 patients between December 2010 and December 2016. On the basis of the 2008 Louisville Statement, we divided the 436 cases into two groups: Simple Group...
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| Veröffentlicht in: | Journal of gastrointestinal surgery 2019-10, Vol.23 (10), p.1949-1956 |
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| container_title | Journal of gastrointestinal surgery |
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| creator | Chen, Te-Hung Yang, Horng-Ren Jeng, Long-Bin Hsu, Shih-Chao Hsu, Chia-Hao Yeh, Chun-Chieh Yang, Mei-Due Chen, William Tzu-Liang |
| description | Background
To report experience of laparoscopic liver resection (LLR) in one center.
Methods
We retrospectively reviewed 436 consecutive LLRs in 411 patients between December 2010 and December 2016. On the basis of the 2008 Louisville Statement, we divided the 436 cases into two groups: Simple Group (
n
= 203) and Difficult Group (
n
= 233).
Results
The indications were HCC (
n
= 194), colorectal cancer liver metastasis (
n
= 156), benign tumors (
n
= 62), hepatolithiasis (
n
= 2), and other malignant lesions (
n
= 22). The median tumor size was 24 mm (range 3 to 130). Procedures of LLR included wedge resection (
n
= 230), one segmentectomy (
n
= 8), two segmentectomies (
n
= 12), left lateral sectionectomy (
n
= 75), right hepatectomy (
n
= 52), left hepatectomy (
n
= 31), extended right hepatectomy (
n
= 2), extended left hepatectomy (
n
= 5), central bisectionectomy (
n
= 3), right posterior sectionectomy (
n
= 12), and right anterior sectionectomy (
n
= 6). The median operative time was 228 min (range 9–843) and median blood loss was 150 ml (range 2–3500). Twenty-five cases required blood transfusion (5.7%). Conversion to open surgery was required in six cases (1.4%). The mean length of stay was 6.4 ± 2.9 days. Overall complication rate was 9.4% and major complication rate was 5%. One patient died of liver failure on the thirtieth postoperative day after a right hepatectomy. We had higher median blood loss (200 vs. 100 ml;
p
|
| doi_str_mv | 10.1007/s11605-018-4023-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2132728607</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2132728607</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-d8fbe1d25b7954973b5ce82101061e1be48ca5a914454f915c36f2bcbe58972b3</originalsourceid><addsrcrecordid>eNp1kE1Lw0AQhhdRbP34AV5kwYuX6M5-x5uE-gGFgih4W5LtRFLaJO62ov_era0KgqcZmGfeGR5CToBdAGPmMgJopjIGNpOMi0zskCFYIzKpud5NPcsh40o9D8hBjDPGwCR2nwwEkxwA7JAU47IvQxd91zeejps3DPQBI_pl07VXdPTeY2iw9Ui7mkqhaVFGjLRp6aRFWmC7xHBE9upyHvF4Ww_J083osbjLxpPb--J6nHlh-DKb2rpCmHJVmVzJ3IhKebQcGDANCBVK60tV5iClknUOygtd88pXqGxueCUOyfkmtw_d6wrj0i2a6HE-L1vsVtFxENxwq5lJ6NkfdNatQpu--6JAgLY6UbChfDIQA9auD82iDB8OmFsbdhvDLllza8NOpJ3TbfKqWuD0Z-NbaQL4Bohp1L5g-D39f-onNRmC5w</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2132131686</pqid></control><display><type>article</type><title>Laparoscopic Liver Resection: Experience of 436 Cases in One Center</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Chen, Te-Hung ; Yang, Horng-Ren ; Jeng, Long-Bin ; Hsu, Shih-Chao ; Hsu, Chia-Hao ; Yeh, Chun-Chieh ; Yang, Mei-Due ; Chen, William Tzu-Liang</creator><creatorcontrib>Chen, Te-Hung ; Yang, Horng-Ren ; Jeng, Long-Bin ; Hsu, Shih-Chao ; Hsu, Chia-Hao ; Yeh, Chun-Chieh ; Yang, Mei-Due ; Chen, William Tzu-Liang</creatorcontrib><description>Background
To report experience of laparoscopic liver resection (LLR) in one center.
Methods
We retrospectively reviewed 436 consecutive LLRs in 411 patients between December 2010 and December 2016. On the basis of the 2008 Louisville Statement, we divided the 436 cases into two groups: Simple Group (
n
= 203) and Difficult Group (
n
= 233).
Results
The indications were HCC (
n
= 194), colorectal cancer liver metastasis (
n
= 156), benign tumors (
n
= 62), hepatolithiasis (
n
= 2), and other malignant lesions (
n
= 22). The median tumor size was 24 mm (range 3 to 130). Procedures of LLR included wedge resection (
n
= 230), one segmentectomy (
n
= 8), two segmentectomies (
n
= 12), left lateral sectionectomy (
n
= 75), right hepatectomy (
n
= 52), left hepatectomy (
n
= 31), extended right hepatectomy (
n
= 2), extended left hepatectomy (
n
= 5), central bisectionectomy (
n
= 3), right posterior sectionectomy (
n
= 12), and right anterior sectionectomy (
n
= 6). The median operative time was 228 min (range 9–843) and median blood loss was 150 ml (range 2–3500). Twenty-five cases required blood transfusion (5.7%). Conversion to open surgery was required in six cases (1.4%). The mean length of stay was 6.4 ± 2.9 days. Overall complication rate was 9.4% and major complication rate was 5%. One patient died of liver failure on the thirtieth postoperative day after a right hepatectomy. We had higher median blood loss (200 vs. 100 ml;
p
< 0.001), higher transfusion rate (8.2 vs. 2.9%;
p
= 0.020), longer median operative time (297 vs. 164 min;
p
< 0.001), higher conversion rate (2.6 vs. 0%;
p
= 0.021), higher complication rate (14.2 vs. 3.9%;
p
< 0.001), and longer mean postoperative hospital stay (6.8 ± 2.9 vs. 5.9 ± 3.0 days;
p
< 0.001) in the Difficult Group.
Conclusions
Laparoscopic liver resection is safe for selected patients in the Difficult Group. On the basis of the 2008 Louisville Statement, selection criteria of LLR are helpful to predict the difficulty of the operation and the postoperative outcomes of LLR.</description><identifier>ISSN: 1091-255X</identifier><identifier>EISSN: 1873-4626</identifier><identifier>DOI: 10.1007/s11605-018-4023-3</identifier><identifier>PMID: 30421118</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Blood Loss, Surgical ; Blood Transfusion ; Colorectal Neoplasms - pathology ; Conversion to Open Surgery ; Female ; Gastroenterology ; Gastrointestinal surgery ; Hepatectomy ; Hepatectomy - adverse effects ; Hepatectomy - methods ; Hepatic Insufficiency ; Humans ; Laparoscopy ; Laparoscopy - adverse effects ; Laparoscopy - methods ; Length of Stay ; Liver ; Liver Neoplasms - pathology ; Liver Neoplasms - secondary ; Liver Neoplasms - surgery ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Operative Time ; Original Article ; Postoperative Complications - etiology ; Retrospective Studies ; Surgery ; Tumor Burden ; Young Adult</subject><ispartof>Journal of gastrointestinal surgery, 2019-10, Vol.23 (10), p.1949-1956</ispartof><rights>The Society for Surgery of the Alimentary Tract 2018</rights><rights>Journal of Gastrointestinal Surgery is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-d8fbe1d25b7954973b5ce82101061e1be48ca5a914454f915c36f2bcbe58972b3</citedby><cites>FETCH-LOGICAL-c372t-d8fbe1d25b7954973b5ce82101061e1be48ca5a914454f915c36f2bcbe58972b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11605-018-4023-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11605-018-4023-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27929,27930,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30421118$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chen, Te-Hung</creatorcontrib><creatorcontrib>Yang, Horng-Ren</creatorcontrib><creatorcontrib>Jeng, Long-Bin</creatorcontrib><creatorcontrib>Hsu, Shih-Chao</creatorcontrib><creatorcontrib>Hsu, Chia-Hao</creatorcontrib><creatorcontrib>Yeh, Chun-Chieh</creatorcontrib><creatorcontrib>Yang, Mei-Due</creatorcontrib><creatorcontrib>Chen, William Tzu-Liang</creatorcontrib><title>Laparoscopic Liver Resection: Experience of 436 Cases in One Center</title><title>Journal of gastrointestinal surgery</title><addtitle>J Gastrointest Surg</addtitle><addtitle>J Gastrointest Surg</addtitle><description>Background
To report experience of laparoscopic liver resection (LLR) in one center.
Methods
We retrospectively reviewed 436 consecutive LLRs in 411 patients between December 2010 and December 2016. On the basis of the 2008 Louisville Statement, we divided the 436 cases into two groups: Simple Group (
n
= 203) and Difficult Group (
n
= 233).
Results
The indications were HCC (
n
= 194), colorectal cancer liver metastasis (
n
= 156), benign tumors (
n
= 62), hepatolithiasis (
n
= 2), and other malignant lesions (
n
= 22). The median tumor size was 24 mm (range 3 to 130). Procedures of LLR included wedge resection (
n
= 230), one segmentectomy (
n
= 8), two segmentectomies (
n
= 12), left lateral sectionectomy (
n
= 75), right hepatectomy (
n
= 52), left hepatectomy (
n
= 31), extended right hepatectomy (
n
= 2), extended left hepatectomy (
n
= 5), central bisectionectomy (
n
= 3), right posterior sectionectomy (
n
= 12), and right anterior sectionectomy (
n
= 6). The median operative time was 228 min (range 9–843) and median blood loss was 150 ml (range 2–3500). Twenty-five cases required blood transfusion (5.7%). Conversion to open surgery was required in six cases (1.4%). The mean length of stay was 6.4 ± 2.9 days. Overall complication rate was 9.4% and major complication rate was 5%. One patient died of liver failure on the thirtieth postoperative day after a right hepatectomy. We had higher median blood loss (200 vs. 100 ml;
p
< 0.001), higher transfusion rate (8.2 vs. 2.9%;
p
= 0.020), longer median operative time (297 vs. 164 min;
p
< 0.001), higher conversion rate (2.6 vs. 0%;
p
= 0.021), higher complication rate (14.2 vs. 3.9%;
p
< 0.001), and longer mean postoperative hospital stay (6.8 ± 2.9 vs. 5.9 ± 3.0 days;
p
< 0.001) in the Difficult Group.
Conclusions
Laparoscopic liver resection is safe for selected patients in the Difficult Group. On the basis of the 2008 Louisville Statement, selection criteria of LLR are helpful to predict the difficulty of the operation and the postoperative outcomes of LLR.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Blood Loss, Surgical</subject><subject>Blood Transfusion</subject><subject>Colorectal Neoplasms - pathology</subject><subject>Conversion to Open Surgery</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Gastrointestinal surgery</subject><subject>Hepatectomy</subject><subject>Hepatectomy - adverse effects</subject><subject>Hepatectomy - methods</subject><subject>Hepatic Insufficiency</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Laparoscopy - adverse effects</subject><subject>Laparoscopy - methods</subject><subject>Length of Stay</subject><subject>Liver</subject><subject>Liver Neoplasms - pathology</subject><subject>Liver Neoplasms - secondary</subject><subject>Liver Neoplasms - surgery</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Operative Time</subject><subject>Original Article</subject><subject>Postoperative Complications - etiology</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Tumor Burden</subject><subject>Young Adult</subject><issn>1091-255X</issn><issn>1873-4626</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kE1Lw0AQhhdRbP34AV5kwYuX6M5-x5uE-gGFgih4W5LtRFLaJO62ov_era0KgqcZmGfeGR5CToBdAGPmMgJopjIGNpOMi0zskCFYIzKpud5NPcsh40o9D8hBjDPGwCR2nwwEkxwA7JAU47IvQxd91zeejps3DPQBI_pl07VXdPTeY2iw9Ui7mkqhaVFGjLRp6aRFWmC7xHBE9upyHvF4Ww_J083osbjLxpPb--J6nHlh-DKb2rpCmHJVmVzJ3IhKebQcGDANCBVK60tV5iClknUOygtd88pXqGxueCUOyfkmtw_d6wrj0i2a6HE-L1vsVtFxENxwq5lJ6NkfdNatQpu--6JAgLY6UbChfDIQA9auD82iDB8OmFsbdhvDLllza8NOpJ3TbfKqWuD0Z-NbaQL4Bohp1L5g-D39f-onNRmC5w</recordid><startdate>20191001</startdate><enddate>20191001</enddate><creator>Chen, Te-Hung</creator><creator>Yang, Horng-Ren</creator><creator>Jeng, Long-Bin</creator><creator>Hsu, Shih-Chao</creator><creator>Hsu, Chia-Hao</creator><creator>Yeh, Chun-Chieh</creator><creator>Yang, Mei-Due</creator><creator>Chen, William Tzu-Liang</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20191001</creationdate><title>Laparoscopic Liver Resection: Experience of 436 Cases in One Center</title><author>Chen, Te-Hung ; Yang, Horng-Ren ; Jeng, Long-Bin ; Hsu, Shih-Chao ; Hsu, Chia-Hao ; Yeh, Chun-Chieh ; Yang, Mei-Due ; Chen, William Tzu-Liang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-d8fbe1d25b7954973b5ce82101061e1be48ca5a914454f915c36f2bcbe58972b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Blood Loss, Surgical</topic><topic>Blood Transfusion</topic><topic>Colorectal Neoplasms - pathology</topic><topic>Conversion to Open Surgery</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Gastrointestinal surgery</topic><topic>Hepatectomy</topic><topic>Hepatectomy - adverse effects</topic><topic>Hepatectomy - methods</topic><topic>Hepatic Insufficiency</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Laparoscopy - adverse effects</topic><topic>Laparoscopy - methods</topic><topic>Length of Stay</topic><topic>Liver</topic><topic>Liver Neoplasms - pathology</topic><topic>Liver Neoplasms - secondary</topic><topic>Liver Neoplasms - surgery</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Operative Time</topic><topic>Original Article</topic><topic>Postoperative Complications - etiology</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Tumor Burden</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, Te-Hung</creatorcontrib><creatorcontrib>Yang, Horng-Ren</creatorcontrib><creatorcontrib>Jeng, Long-Bin</creatorcontrib><creatorcontrib>Hsu, Shih-Chao</creatorcontrib><creatorcontrib>Hsu, Chia-Hao</creatorcontrib><creatorcontrib>Yeh, Chun-Chieh</creatorcontrib><creatorcontrib>Yang, Mei-Due</creatorcontrib><creatorcontrib>Chen, William Tzu-Liang</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of gastrointestinal surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, Te-Hung</au><au>Yang, Horng-Ren</au><au>Jeng, Long-Bin</au><au>Hsu, Shih-Chao</au><au>Hsu, Chia-Hao</au><au>Yeh, Chun-Chieh</au><au>Yang, Mei-Due</au><au>Chen, William Tzu-Liang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Laparoscopic Liver Resection: Experience of 436 Cases in One Center</atitle><jtitle>Journal of gastrointestinal surgery</jtitle><stitle>J Gastrointest Surg</stitle><addtitle>J Gastrointest Surg</addtitle><date>2019-10-01</date><risdate>2019</risdate><volume>23</volume><issue>10</issue><spage>1949</spage><epage>1956</epage><pages>1949-1956</pages><issn>1091-255X</issn><eissn>1873-4626</eissn><abstract>Background
To report experience of laparoscopic liver resection (LLR) in one center.
Methods
We retrospectively reviewed 436 consecutive LLRs in 411 patients between December 2010 and December 2016. On the basis of the 2008 Louisville Statement, we divided the 436 cases into two groups: Simple Group (
n
= 203) and Difficult Group (
n
= 233).
Results
The indications were HCC (
n
= 194), colorectal cancer liver metastasis (
n
= 156), benign tumors (
n
= 62), hepatolithiasis (
n
= 2), and other malignant lesions (
n
= 22). The median tumor size was 24 mm (range 3 to 130). Procedures of LLR included wedge resection (
n
= 230), one segmentectomy (
n
= 8), two segmentectomies (
n
= 12), left lateral sectionectomy (
n
= 75), right hepatectomy (
n
= 52), left hepatectomy (
n
= 31), extended right hepatectomy (
n
= 2), extended left hepatectomy (
n
= 5), central bisectionectomy (
n
= 3), right posterior sectionectomy (
n
= 12), and right anterior sectionectomy (
n
= 6). The median operative time was 228 min (range 9–843) and median blood loss was 150 ml (range 2–3500). Twenty-five cases required blood transfusion (5.7%). Conversion to open surgery was required in six cases (1.4%). The mean length of stay was 6.4 ± 2.9 days. Overall complication rate was 9.4% and major complication rate was 5%. One patient died of liver failure on the thirtieth postoperative day after a right hepatectomy. We had higher median blood loss (200 vs. 100 ml;
p
< 0.001), higher transfusion rate (8.2 vs. 2.9%;
p
= 0.020), longer median operative time (297 vs. 164 min;
p
< 0.001), higher conversion rate (2.6 vs. 0%;
p
= 0.021), higher complication rate (14.2 vs. 3.9%;
p
< 0.001), and longer mean postoperative hospital stay (6.8 ± 2.9 vs. 5.9 ± 3.0 days;
p
< 0.001) in the Difficult Group.
Conclusions
Laparoscopic liver resection is safe for selected patients in the Difficult Group. On the basis of the 2008 Louisville Statement, selection criteria of LLR are helpful to predict the difficulty of the operation and the postoperative outcomes of LLR.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>30421118</pmid><doi>10.1007/s11605-018-4023-3</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1091-255X |
| ispartof | Journal of gastrointestinal surgery, 2019-10, Vol.23 (10), p.1949-1956 |
| issn | 1091-255X 1873-4626 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2132728607 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adult Aged Aged, 80 and over Blood Loss, Surgical Blood Transfusion Colorectal Neoplasms - pathology Conversion to Open Surgery Female Gastroenterology Gastrointestinal surgery Hepatectomy Hepatectomy - adverse effects Hepatectomy - methods Hepatic Insufficiency Humans Laparoscopy Laparoscopy - adverse effects Laparoscopy - methods Length of Stay Liver Liver Neoplasms - pathology Liver Neoplasms - secondary Liver Neoplasms - surgery Male Medicine Medicine & Public Health Middle Aged Operative Time Original Article Postoperative Complications - etiology Retrospective Studies Surgery Tumor Burden Young Adult |
| title | Laparoscopic Liver Resection: Experience of 436 Cases in One Center |
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