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- Publisher Website: 10.1097/SLA.0000000000004227
- PMID: 32657940
- WOS: WOS:000793253900008
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Article: Transferability of liver transplantation experience to complex liver resection for locally advanced hepatobiliary malignancy - Lessons learnt from 3 decades of single center experience
Title | Transferability of liver transplantation experience to complex liver resection for locally advanced hepatobiliary malignancy - Lessons learnt from 3 decades of single center experience |
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Authors | |
Keywords | ALPPS cholangiocarcinoma complex liver resection complication deceased donor liver transplantation |
Issue Date | 2020 |
Publisher | Lippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.com |
Citation | Annals of Surgery, 2020, Epub 2020-07-09 How to Cite? |
Abstract | Objective: To study the impact of LT experience on the outcome of CLR for locally advanced hepatobiliary malignancy SUMMARY OF BACKGROUND DATA:: Despite evolution in LT knowledge and surgical techniques in the past decades, there is yet data to evaluate the significance of LT experience in performing CLR.
Methods: Postoperative outcome after CLR between 1995 and 2019 were reviewed and correlated with LT experience in a single center with both LT and CLR service. CLR was defined as hepatectomy with vasculobiliary reconstruction, or multivisceral resection, central bisectionectomy (S4/5/8), or associating liver partition and portal vein ligation for staged hepatectomy. Spearman rank correlation and receiver operating characteristic analysis were used to define the association between CLR-related outcomes and LT experience.
Results: With cumulative single-center experience of 1452 LT, 222 CLR were performed during the study period [hepatectomy with biliary (27.0%), or vascular (21.2%) reconstruction, with multivisceral resections (9.9%), with associating liver partition and portal vein ligation for staged hepatectomy (18.5%)] mainly for hepatocellular carcinoma (53.2%), and hilar cholangiocarcinoma (14%). Median tumor size was 7.0 cm. Other features include macrovascular invasion (23.4%), and juxta-visceral invasion (14%). Major postoperative complication rate was 25.2% and mortality rate was 6.3%. CLR-complication rate was inversely associated with LT experience (R = -0.88, P < 0.005). Receiver operator characteristic analysis revealed the cutoff for LT experience to have the greatest influence on CLR was 95 with a sensitivity of 100% and Youden index of 1. Multivariable analysis showed that blood transfusion, prolonged operating time, LT experience =95 were associated with major postoperative complications.
Conclusion: LT experience was complimentary to CLR for locally advanced hepatobiliary malignancy with improved postoperative outcome. |
Persistent Identifier | http://hdl.handle.net/10722/305040 |
ISSN | 2023 Impact Factor: 7.5 2023 SCImago Journal Rankings: 2.729 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Chan, ACY | - |
dc.contributor.author | Chok, KSH | - |
dc.contributor.author | Dai, J | - |
dc.contributor.author | Tsang, SHY | - |
dc.contributor.author | Cheung, TT | - |
dc.contributor.author | Poon, R | - |
dc.contributor.author | Fan, ST | - |
dc.contributor.author | Lo, CM | - |
dc.date.accessioned | 2021-10-05T02:38:53Z | - |
dc.date.available | 2021-10-05T02:38:53Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | Annals of Surgery, 2020, Epub 2020-07-09 | - |
dc.identifier.issn | 0003-4932 | - |
dc.identifier.uri | http://hdl.handle.net/10722/305040 | - |
dc.description.abstract | Objective: To study the impact of LT experience on the outcome of CLR for locally advanced hepatobiliary malignancy SUMMARY OF BACKGROUND DATA:: Despite evolution in LT knowledge and surgical techniques in the past decades, there is yet data to evaluate the significance of LT experience in performing CLR. Methods: Postoperative outcome after CLR between 1995 and 2019 were reviewed and correlated with LT experience in a single center with both LT and CLR service. CLR was defined as hepatectomy with vasculobiliary reconstruction, or multivisceral resection, central bisectionectomy (S4/5/8), or associating liver partition and portal vein ligation for staged hepatectomy. Spearman rank correlation and receiver operating characteristic analysis were used to define the association between CLR-related outcomes and LT experience. Results: With cumulative single-center experience of 1452 LT, 222 CLR were performed during the study period [hepatectomy with biliary (27.0%), or vascular (21.2%) reconstruction, with multivisceral resections (9.9%), with associating liver partition and portal vein ligation for staged hepatectomy (18.5%)] mainly for hepatocellular carcinoma (53.2%), and hilar cholangiocarcinoma (14%). Median tumor size was 7.0 cm. Other features include macrovascular invasion (23.4%), and juxta-visceral invasion (14%). Major postoperative complication rate was 25.2% and mortality rate was 6.3%. CLR-complication rate was inversely associated with LT experience (R = -0.88, P < 0.005). Receiver operator characteristic analysis revealed the cutoff for LT experience to have the greatest influence on CLR was 95 with a sensitivity of 100% and Youden index of 1. Multivariable analysis showed that blood transfusion, prolonged operating time, LT experience </=95 were associated with major postoperative complications. Conclusion: LT experience was complimentary to CLR for locally advanced hepatobiliary malignancy with improved postoperative outcome. | - |
dc.language | eng | - |
dc.publisher | Lippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.com | - |
dc.relation.ispartof | Annals of Surgery | - |
dc.rights | This is a non-final version of an article published in final form in (provide complete journal citation) | - |
dc.subject | ALPPS | - |
dc.subject | cholangiocarcinoma | - |
dc.subject | complex liver resection | - |
dc.subject | complication | - |
dc.subject | deceased donor liver transplantation | - |
dc.title | Transferability of liver transplantation experience to complex liver resection for locally advanced hepatobiliary malignancy - Lessons learnt from 3 decades of single center experience | - |
dc.type | Article | - |
dc.identifier.email | Chan, ACY: acchan@hku.hk | - |
dc.identifier.email | Chok, KSH: chok6275@hku.hk | - |
dc.identifier.email | Dai, J: daiwc@hku.hk | - |
dc.identifier.email | Cheung, TT: cheung68@hku.hk | - |
dc.identifier.email | Poon, R: poontp@hku.hk | - |
dc.identifier.email | Fan, ST: stfan@HKUCC-COM.hku.hk | - |
dc.identifier.email | Lo, CM: chungmlo@hkucc.hku.hk | - |
dc.identifier.authority | Chan, ACY=rp00310 | - |
dc.identifier.authority | Chok, KSH=rp02110 | - |
dc.identifier.authority | Cheung, TT=rp02129 | - |
dc.identifier.authority | Poon, R=rp00446 | - |
dc.identifier.authority | Fan, ST=rp00355 | - |
dc.identifier.authority | Lo, CM=rp00412 | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1097/SLA.0000000000004227 | - |
dc.identifier.pmid | 32657940 | - |
dc.identifier.hkuros | 326051 | - |
dc.identifier.volume | Epub 2020-07-09 | - |
dc.identifier.isi | WOS:000793253900008 | - |
dc.publisher.place | United States | - |