ArticleSurgical endoscopy2024
Technical aspects and learning curve of complex laparoscopic hepatectomy: how we do it.
Article in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Minimally invasive hepatectomy in ambulatory surgery: a retrospective study on prospectively collected data in a consecutive patient cohort.Surgical endoscopy · 2026Article
- Indocyanine green fluorescence navigation with 4K overlay vs. conventional laparoscopic liver resection: a propensity score-matched analysis (liver-light study).Surgical endoscopy · 2025Article
- Learning curve analysis of 100 consecutive robotic liver resections.Surgical endoscopy · 2025Article
- Transforming liver surgery: the shift from traditional resections to minimally invasive and parenchymal-sparing techniques.Hepatobiliary surgery and nutrition · 2024Article
- Article
- Benefits of laparoscopic liver resection for liver tumors in obese patients: a meta-analysis.Frontiers in oncology · 2024Review
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionLaparoscopic 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.
methodsWe 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.
resultsPostoperative 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.
conclusionCLH 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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Registered trials
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