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http://hdl.handle.net/1942/37714
Title: | A multicenter cohort analysis of laparoscopic hepatic caudate lobe resection | Authors: | Cappelle, M Aghayan, DL van der Poel, MJ Besselink, MG SERGEANT, Gregory Edwin, B Parmentier, I De Meyere, C Vansteenkiste, F D'Hondt, M |
Issue Date: | 2020 | Publisher: | SPRINGER | Source: | LANGENBECKS ARCHIVES OF SURGERY, 405 (2) , p. 181 -189 | 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. | Keywords: | Laparoscopic caudate lobe resection;Caudate lobectomy;Colorectal liver metastasis | Document URI: | http://hdl.handle.net/1942/37714 | ISSN: | 1435-2443 | e-ISSN: | 1435-2451 | DOI: | 10.1007/s00423-020-01867-2 | ISI #: | 000522910400001 | Rights: | Springer-Verlag GmbH Germany | Category: | A1 | Type: | Journal Contribution |
Appears in Collections: | Research publications |
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