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Article: Robotic versus laparoscopic liver resections for hepatolithiasis: an international multicenter propensity score matched analysis

TitleRobotic versus laparoscopic liver resections for hepatolithiasis: an international multicenter propensity score matched analysis
Authors
KeywordsHepatolithiasis
Laparoscopic liver resection
Minimally invasive liver surgery
Recurrent pyogenic cholangitis
Robotic liver resection
Issue Date17-Apr-2023
PublisherSpringer
Citation
Surgical Endoscopy, 2023, v. 37, n. 8, p. 5855-5864 How to Cite?
Abstract

Introduction

Minimally invasive liver resection (MILR) is widely recognized as a safe and beneficial procedure in the treatment of both malignant and benign liver diseases. Hepatolithiasis has traditionally been reported to be endemic only in East Asia, but has seen a worldwide uptrend in recent decades with increasingly frequent and invasive endoscopic instrumentation of the biliary tract for a myriad of conditions. To date, there has been a woeful lack of high-quality evidence comparing the laparoscopic (LLR) and robotic (RLR) approaches to treatment hepatolithiasis.

Methods

This is an international multicenter retrospective analysis of 273 patients who underwent RLR or LRR for hepatolithiasis at 33 centers in 2003–2020. The baseline clinicopathological characteristics and perioperative outcomes of these patients were assessed. To minimize selection bias, 1:1 (48 and 48 cases of RLR and LLR, respectively) and 1:2 (37 and 74 cases of RLR and LLR, respectively) propensity score matching (PSM) was performed.

Results

In the unmatched cohort, 63 (23.1%) patients underwent RLR, and 210 (76.9%) patients underwent LLR. Patient clinicopathological characteristics were comparable between the groups after PSM. After 1:1 and 1:2 PSM, RLR was associated with less blood loss (p = 0.003 in 1:2 PSM; p = 0.005 in 1:1 PSM), less patients with blood loss greater than 300 ml (p = 0.024 in 1:2 PSM; p = 0.027 in 1:1 PSM), and lower conversion rate to open surgery (p = 0.003 in 1:2 PSM; p < 0.001 in 1:1 PSM). There was no significant difference between RLR and LLR in use of the Pringle maneuver, median Pringle maneuver duration, 30-day readmission rate, postoperative morbidity, major morbidity, reoperation, and mortality.

Conclusion

Both RLR and LLR were safe and feasible for hepatolithiasis. RLR was associated with significantly less blood loss and lower open conversion rate.


Persistent Identifierhttp://hdl.handle.net/10722/331236
ISSN
2023 Impact Factor: 2.4
2023 SCImago Journal Rankings: 1.120
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorKwak, BJ-
dc.contributor.authorLee, JH-
dc.contributor.authorChin, KM-
dc.contributor.authorSyn, NL-
dc.contributor.authorChoi, SH-
dc.contributor.authorCheung, TT-
dc.contributor.authorChiow, AKH-
dc.contributor.authorSucandy, I-
dc.contributor.authorMarino, MV-
dc.contributor.authorPrieto, M-
dc.contributor.authorChong, CC-
dc.contributor.authorChoi, GH-
dc.contributor.authorEfanov, M-
dc.contributor.authorKingham, TP-
dc.contributor.authorSutcliffe, RP-
dc.contributor.authorTroisi, RI-
dc.contributor.authorPratschke, J-
dc.contributor.authorWang, XY-
dc.contributor.authorD'Hondt, M-
dc.contributor.authorTang, CN-
dc.contributor.authorMishima, K-
dc.contributor.authorWakabayashi, G-
dc.contributor.authorCherqui, D-
dc.contributor.authorAghayan, DL-
dc.contributor.authorEdwin, B-
dc.contributor.authorScatton, O-
dc.contributor.authorSugioka, A-
dc.contributor.authorLong, TCD-
dc.contributor.authorFondevila, C-
dc.contributor.authorAlzoubi, M-
dc.contributor.authorAbu Hilal, M-
dc.contributor.authorRuzzenente, A-
dc.contributor.authorFerrero, A-
dc.contributor.authorHerman, P-
dc.contributor.authorLee, B-
dc.contributor.authorFuks, D-
dc.contributor.authorCipriani, F-
dc.contributor.authorLiu, Q-
dc.contributor.authorAldrighetti, L-
dc.contributor.authorLiu, R-
dc.contributor.authorHan, HS-
dc.contributor.authorGoh, BKP-
dc.date.accessioned2023-09-21T06:53:56Z-
dc.date.available2023-09-21T06:53:56Z-
dc.date.issued2023-04-17-
dc.identifier.citationSurgical Endoscopy, 2023, v. 37, n. 8, p. 5855-5864-
dc.identifier.issn0930-2794-
dc.identifier.urihttp://hdl.handle.net/10722/331236-
dc.description.abstract<h3>Introduction</h3><p>Minimally invasive liver resection (MILR) is widely recognized as a safe and beneficial procedure in the treatment of both malignant and benign liver diseases. Hepatolithiasis has traditionally been reported to be endemic only in East Asia, but has seen a worldwide uptrend in recent decades with increasingly frequent and invasive endoscopic instrumentation of the biliary tract for a myriad of conditions. To date, there has been a woeful lack of high-quality evidence comparing the laparoscopic (LLR) and robotic (RLR) approaches to treatment hepatolithiasis.</p><h3>Methods</h3><p>This is an international multicenter retrospective analysis of 273 patients who underwent RLR or LRR for hepatolithiasis at 33 centers in 2003–2020. The baseline clinicopathological characteristics and perioperative outcomes of these patients were assessed. To minimize selection bias, 1:1 (48 and 48 cases of RLR and LLR, respectively) and 1:2 (37 and 74 cases of RLR and LLR, respectively) propensity score matching (PSM) was performed.</p><h3>Results</h3><p>In the unmatched cohort, 63 (23.1%) patients underwent RLR, and 210 (76.9%) patients underwent LLR. Patient clinicopathological characteristics were comparable between the groups after PSM. After 1:1 and 1:2 PSM, RLR was associated with less blood loss (p = 0.003 in 1:2 PSM; p = 0.005 in 1:1 PSM), less patients with blood loss greater than 300 ml (p = 0.024 in 1:2 PSM; p = 0.027 in 1:1 PSM), and lower conversion rate to open surgery (p = 0.003 in 1:2 PSM; p < 0.001 in 1:1 PSM). There was no significant difference between RLR and LLR in use of the Pringle maneuver, median Pringle maneuver duration, 30-day readmission rate, postoperative morbidity, major morbidity, reoperation, and mortality.</p><h3>Conclusion</h3><p>Both RLR and LLR were safe and feasible for hepatolithiasis. RLR was associated with significantly less blood loss and lower open conversion rate.</p>-
dc.languageeng-
dc.publisherSpringer-
dc.relation.ispartofSurgical Endoscopy-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectHepatolithiasis-
dc.subjectLaparoscopic liver resection-
dc.subjectMinimally invasive liver surgery-
dc.subjectRecurrent pyogenic cholangitis-
dc.subjectRobotic liver resection-
dc.titleRobotic versus laparoscopic liver resections for hepatolithiasis: an international multicenter propensity score matched analysis-
dc.typeArticle-
dc.identifier.doi10.1007/s00464-023-10051-8-
dc.identifier.scopuseid_2-s2.0-85152910459-
dc.identifier.volume37-
dc.identifier.issue8-
dc.identifier.spage5855-
dc.identifier.epage5864-
dc.identifier.eissn1432-2218-
dc.identifier.isiWOS:000973539000001-
dc.identifier.issnl0930-2794-

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