ArticleSurgical endoscopy2018
Critical appraisal of the impact of individual surgeon experience on the outcomes of laparoscopic liver resection in the modern era: collective experience of multiple surgeons at a single institution with 324 consecutive cases.
Article in Surgical endoscopy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- Efficacy of Laparoscopic HepatectomyFrontiers in oncology · 2021Pooled it
- Adoption of pure laparoscopic liver resections: a single-institution experience with the first 1000 consecutive resections.Surgical endoscopy · 2026Article
- Can liver venous system diameters predict difficulty of laparoscopic liver resection?BMC surgery · 2025Article
- Towards a Standardization of Learning Curve Assessment in Minimally Invasive Liver Surgery.Annals of surgery · 2024Article
- Effect of Preoperative Malnutrition Based on Albumin and BMI on Hepatocellular Carcinoma Surgery and Prediction of Risk Factors of Complications.Journal of gastrointestinal cancer · 2024Review
- International experts consensus guidelines on robotic liver resection in 2023.World journal of gastroenterology · 2023Review
- Impact of non-liver-related previous abdominal surgery on the difficulty of minimally invasive liver resections: a propensity score-matched controlled study.Surgical endoscopy · 2022Article
- Impact of liver cirrhosis on the difficulty of minimally-invasive liver resections: a 1:1 coarsened exact-matched controlled study.Surgical endoscopy · 2021Article
- Novel method of intraoperative liver tumour localisation with indocyanine green and near-infrared imaging.Singapore medical journal · 2021Article
- Current status of laparoscopic liver resection for the management of colorectal liver metastases.Journal of gastrointestinal oncology · 2020Review
- Critical Appraisal of the Impact of the Systematic Adoption of Advanced Minimally Invasive Hepatobiliary and Pancreatic Surgery on the Surgical Management of Mirizzi Syndrome.World journal of surgery · 2019Article
- Perioperative Outcomes of Laparoscopic Repeat Liver Resection for Recurrent HCC: Comparison with Open Repeat Liver Resection for Recurrent HCC and Laparoscopic Resection for Primary HCC.World journal of surgery · 2019Article
- Perioperative Outcomes of Laparoscopic Minor Hepatectomy for Hepatocellular Carcinoma in the Elderly.World journal of surgery · 2018Article
- Changing trends and outcomes associated with the adoption of minimally invasive hepatectomy: a contemporary single-institution experience with 400 consecutive resections.Surgical endoscopy · 2018Article
- The Ethical Dilemma in the Surgical Management of Low Grade Gliomas According to the Variable Availability of Resources and Surgeon Experience.Asian journal of neurosurgeryReview
- Early experience with laparoscopic liver resection for spontaneously ruptured hepatocellular carcinoma.Journal of minimal access surgeryArticle
- Outcome of minimally invasive liver resection for extrapancreatic biliary malignancies: A single-institutional experience.Journal of minimal access surgeryArticle
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMost studies analyzing the learning experience of laparoscopic liver resection (LLR) focused on the experience of one or two expert pioneering surgeons. This study aims to critically analyze the impact of individual surgeon experience on the outcomes of LLR based on the contemporary collective experiences of multiple surgeons at single institution.
methodsRetrospective review of 324 consecutive LLR from 2006 to 2016. The cases were performed by 10 surgeons over various time periods. Four surgeons had individual experience with <20 cases, four surgeons with 20-30 cases, and two surgeons with >90 cases. The cohort was divided into two groups: comparing a surgeon's experience between the first 20, 30, 40, and 50 cases with patients treated thereafter. Similarly, we performed subset analyses for anterolateral lesions, posterosuperior lesions, and major hepatectomies.
resultsAs individual surgeons gained increasing experience, this was significantly associated with older patients being operated, decreased hand-assistance, larger tumor size, increased liver resections, increased major resections, and increased resections of tumors located at the posterosuperior segments. This resulted in significantly longer operation time and increased use of Pringle maneuver but no difference in other outcomes. Analysis of LLR for tumors in the posterosuperior segments demonstrated that there was a significant decrease in conversion rates after a surgeon had experience with 20 LLR. For major hepatectomies, there was a significant decrease in morbidity, mortality, and length of stay after acquiring experience with 20 LLR.
conclusionLLR can be safely adopted today especially for lesions in the anterolateral segments. LLR for lesions in the difficult posterosuperior segments and major hepatectomies especially in cirrhosis should only be attempted by surgeons who have acquired a minimum experience with 20 LLR.
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