We have located links that may give you full text access.
Global Outcomes Benchmarks in Laparoscopic Liver Surgery for Segments 7 and 8: International Multicenter Analysis.
Journal of the American College of Surgeons 2024 April 26
BACKGROUND: In recent years, there has been growing interest in laparoscopic liver resection (LLR) and the audit of the results of surgical procedures. The aim of this study was to define reference values for LLR in segments 7 and 8.
METHODS: Data on LLR in segments 7 and 8 between January 2000 and December 2020 were collected from 19 expert centers. Reference cases were defined as no prior hepatectomy, ASA <3, body mass index <35 kg/m2, no chronic kidney disease, no cirrhosis and portal hypertension, no chronic obstructive pulmonary disease (FEV1<80%), and no cardiac disease. Reference values were obtained from the 75th percentile of the medians of all reference centers.
RESULTS: Of 585 patients, 461 (78.8%) met the reference criteria. The overall complication rate was 27.5% (6% were Clavien-Dindo≥3a) with a mean CCI of 7.5 ± 16.5. At 90-day follow-up, the references values for overall complications were 31%, Clavien≥3a 7.4%, conversion 4.4%, hospital stay < 6 days, and readmission rate < 8.33%, respectively. Eastern centers patients categorized as low risk had a lower rate of overall complications (20.9% vs 31.2%, p=0.01) with similar Clavien-Dindo≥3a (5.5% and 4.8%, p=0.83) compared to Western centers, respectively.
CONCLUSION: This study shows the need to establish standards for the postoperative outcomes in LLR based on the complexity of the resection and the location of the lesions.
METHODS: Data on LLR in segments 7 and 8 between January 2000 and December 2020 were collected from 19 expert centers. Reference cases were defined as no prior hepatectomy, ASA <3, body mass index <35 kg/m2, no chronic kidney disease, no cirrhosis and portal hypertension, no chronic obstructive pulmonary disease (FEV1<80%), and no cardiac disease. Reference values were obtained from the 75th percentile of the medians of all reference centers.
RESULTS: Of 585 patients, 461 (78.8%) met the reference criteria. The overall complication rate was 27.5% (6% were Clavien-Dindo≥3a) with a mean CCI of 7.5 ± 16.5. At 90-day follow-up, the references values for overall complications were 31%, Clavien≥3a 7.4%, conversion 4.4%, hospital stay < 6 days, and readmission rate < 8.33%, respectively. Eastern centers patients categorized as low risk had a lower rate of overall complications (20.9% vs 31.2%, p=0.01) with similar Clavien-Dindo≥3a (5.5% and 4.8%, p=0.83) compared to Western centers, respectively.
CONCLUSION: This study shows the need to establish standards for the postoperative outcomes in LLR based on the complexity of the resection and the location of the lesions.
Full text links
Related Resources
Trending Papers
Autoimmune Hemolytic Anemias: Classifications, Pathophysiology, Diagnoses and Management.International Journal of Molecular Sciences 2024 April 13
Executive Summary: State-of-the-Art Review: Unintended Consequences: Risk of Opportunistic Infections Associated with Long-term Glucocorticoid Therapies in Adults.Clinical Infectious Diseases 2024 April 11
Clinical practice guidelines on the management of status epilepticus in adults: A systematic review.Epilepsia 2024 April 13
Finerenone: From the Mechanism of Action to Clinical Use in Kidney Disease.Pharmaceuticals 2024 March 27
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app