AI Article Synopsis
- Laparoscopic liver surgery, particularly complex laparoscopic hepatectomy (CLH), offers benefits like fewer complications and faster recovery, but requires highly skilled surgeons.
- In a study at our center, 63 out of 135 laparoscopic liver resections were identified as CLH, and the learning curve was analyzed through operation times and blood loss.
- Results showed low complication rates (4.8%) and a 90-day mortality of 3.2%, with significant improvements observed after 20 operations, indicating that CLH is safe and effective, warranting further research on surgical training.
Article Abstract
Introduction: Laparoscopic liver surgery has advanced significantly, offering benefits, such as reduced intraoperative complications and quicker recovery. However, complex laparoscopic hepatectomy (CLH) is technically demanding, requiring skilled surgeons. This study aims to share technical aspects, insightful tips, and outcomes of CLH at our center, focusing on the safety and learning curve.
Methods: We reviewed all patients undergoing liver resection at our center from July 2017 to December 2023, focusing on those who underwent CLH. Of 135 laparoscopic liver resections, 63 (46.7%) were CLH. The learning curve of CLH was also assessed through linear and piecewise regression analyses considering the operation time and intraoperative blood loss.
Results: Postoperative complications occurred only in 4.8% of patients, with a 90-day mortality rate of 3.2%. The mean operation time and blood loss significantly decreased after the first 20 operations, marking the learning curve's optimal cut-off. Significant improvements in R0 resection (p = 0.024) and 90-day mortality (p = 0.035) were noted beyond the learning curve threshold.
Conclusion: CLH is a safe and effective approach, with a relatively short learning curve of 20 operations. Future large-scale studies should further investigate the impact of surgical experience on CLH outcomes to establish guidelines for training programs.
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| http://dx.doi.org/10.1007/s00464-024-11002-7 | DOI Listing |
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