ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2019
Laparoscopic Versus Open Major Hepatectomy: Analysis of Clinical Outcomes and Cost Effectiveness in a High-Volume Center.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 4 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
24 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Economic analysis of open versus laparoscopic versus robotic hepatectomy: a systematic review and meta-analysis.The European journal of health economics : HEPAC : health economics in prevention and care · 2021Pooled it
- Systematic review of perioperative and oncologic outcomes of minimally-invasive surgery for hilar cholangiocarcinoma.Updates in surgery · 2021Pooled it
- Laparoscopic versus open liver resection for intrahepatic cholangiocarcinoma: the first meta-analysis.Langenbeck's archives of surgery · 2020Pooled it
- Laparoscopic versus open major liver resection for hepatocellular carcinoma: systematic review and meta-analysis of comparative cohort studies.BMC cancer · 2019Pooled it
- Respiratory muscle training with electronic devices in the postoperative period of hepatectomy: A randomized study.World journal of hepatology · 2023Trial
- Minimally invasive versus open liver resection for benign disease: analysis of textbook outcomes according to difficulty of resections and role of the robotic approach.Surgical endoscopy · 2026Article
- Surgical microwave ablation of 397 neuroendocrine liver metastases: a retrospective cohort analysis of 16 years of experience.Surgical endoscopy · 2024Article
- Trends in hospital volume and operative mortality in hepato-biliary surgery in Veneto region, Italy.Updates in surgery · 2023Article
- Laparoscopic Resection of Perihilar Cholangiocarcinoma Type IIIb: A Video Demonstration of No-Touch En-Block Technique and Radical Lymphadenectomy.Annals of surgical oncology · 2023Article
- The Outcome of Conversion to Hand-Assisted Laparoscopic Surgery in Laparoscopic Liver Resection.Journal of clinical medicine · 2023Article
- Implementation and Outcome of Robotic Liver Surgery in the Netherlands: A Nationwide Analysis.Annals of surgery · 2023Article
- Laparoscopic versus open surgery for perihilar cholangiocarcinoma: a multicenter propensity score analysis of short- term outcomes.BMC cancer · 2023Article
- Article
- Routine Postoperative Antibiotic Prophylaxis Offers No Benefit after Hepatectomy-A Systematic Review and Meta-Analysis.Antibiotics (Basel, Switzerland) · 2022Review
- [Advantages and future perspectives of laparoscopic liver surgery].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2021Review
- Total Laparoscopic Resection of Hilar Cholangiocarcinoma Type 3b: Applying a Parachute Technique for Hepaticojejunostomy.Annals of surgical oncology · 2021Article
- Laparoscopic Left Hepatectomy with Middle Hepatic Vein Resection for Hepatocellular Carcinoma with Extrahepatic Portal Vein Obstruction.The American journal of case reports · 2021Article
- Analysis of economic impact of laparoscopic liver resection according to surgical difficulty.Surgical endoscopy · 2021Review
- Surgical Management of Sigmoid Volvulus: A Multicenter Observational Study.Annals of coloproctology · 2020Article
- Impact of Surgeon Volume on Outcomes and Expenditure Among Medicare Beneficiaries Undergoing Liver Resection: the Effect of Minimally Invasive Surgery.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2020Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundConsidering the increasing evidence on the feasibility of laparoscopic major hepatectomies (LMH), their clinical outcomes and associated costs were herein evaluated compared to open (OMH).
methodsMajor contributors of perioperative expenses were considered. With respect to the occurrence of conversion, a primary intention-to-treat analysis including conversions in the LMH group (ITT-A) was performed. An additional per-protocol analysis excluding conversions (PP-A) was undertaken, with calculation of additional costs of conversion analysis.
resultsOne hundred forty-five LMH and 61 OMH were included (14.5% conversion rate). At the ITT-A, LMH showed lower blood loss (p < 0.001) and morbidity (global p 0.037, moderate p 0.037), shorter hospital stay (p 0.035), and a lower need for intra- and postoperative red blood cells transfusions (p < 0.001), investigations (p 0.004), and antibiotics (p 0.002). The higher intraoperative expenses (+ 32.1%, p < 0.001) were offset by postoperative savings (- 27.2%, p 0.030), resulting in a global cost-neutrality of LMH (- 7.2%, p 0.807). At the PP-A, completed LMH showed also lower severe complications (p 0.042), interventional procedures (p 0.027), and readmission rates (p 0.031), and postoperative savings increased to - 71.3% (p 0.003) resulting in a 29.9% cost advantage of completed LMH (p 0.020). However, the mean additional cost of conversion was significant.
conclusionsCompleted LMH exhibit a high potential treatment effect compared to OMH and are associated to significant cost savings. Despite some of these benefits may be jeopardized by conversion, a program of LMH can still provide considerable clinical benefits without cost disadvantage and appears worth to be implemented in high-volume centers.
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