Evidence map›Paper›PMID 40828219›Full record

ArticleUpdates in surgery2026

Clinical and biological impact of conversion on outcomes of minimally invasive liver surgery: a multimodal analysis.

Mohamed El-Mahrouk, Rebecca Marino, Diletta Corallino, Vincenzo Artuso, Federica Cipriani, Marco Catena, Robert Sucher, Luca Aldrighetti, Francesca Ratti

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Updates in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Mohamed El-MahroukDivision of General, Visceral and Transplantation Surgery, Department of Surgery, Medical University of Graz, 8036, Graz, Austria.
Rebecca MarinoHepatobiliary Surgery Division, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, Milan, Italy.
Diletta CorallinoHepatobiliary Surgery Division, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, Milan, Italy.
Vincenzo ArtusoHepatobiliary Surgery Division, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, Milan, Italy.
Federica CiprianiHepatobiliary Surgery Division, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, Milan, Italy.
Marco CatenaHepatobiliary Surgery Division, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, Milan, Italy.
Robert SucherDivision of General, Visceral and Transplantation Surgery, Department of Surgery, Medical University of Graz, 8036, Graz, Austria.
Luca AldrighettiHepatobiliary Surgery Division, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, Milan, Italy.
Francesca RattiHepatobiliary Surgery Division, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, Milan, Italy. ratti.francesca@hsr.it.ORCID http://orcid.org/0000-0002-8108-9064

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Minimally invasive liver surgery (MILS) offers several advantages over open liver surgery (OLS), but the underlying mechanisms remain unclear. This study compares inflammatory marker levels between OLS and MILS and examines the impact of conversion. Patients undergoing liver resection at San Raffaele Hospital (September 2022-May 2023) were prospectively enrolled. Plasma inflammatory markers were measured over 120 postoperative hours and analyzed between cohorts. Among 118 liver resections (50 laparoscopic, 38 robotic, 30 open), the OLS group showed higher intraoperative plasma lactate (4.6 vs. 3.8 mmol/L; p < 0.04) and levels one hour postoperatively (3.9 vs. 2.4 mmol/L; p = 0.02). CRP and IL-6 levels were significantly higher in OLS (p < 0.001). No significant differences were found between laparoscopic and robotic approaches. However, conversion led to increased lactate (p = 0.018), CRP (p < 0.05), and IL-6 (p < 0.001) also compared with upfront OLS. MILS significantly improves biological markers as compared to OLS. However, conversion not only negates these benefits but also amplifies surgical stress and inflammation.

Indexed as

Conversion to Open SurgeryHepatectomyLaparoscopyMinimally Invasive Surgical ProceduresRobotic Surgical ProceduresAgedBiomarkersC-Reactive ProteinFemaleHumansInflammationInterleukin-6Lactic AcidMaleMiddle AgedProspective StudiesBiomarkersC-Reactive ProteinInterleukin-6Lactic AcidHepatobiliary surgeryInflammatory biomarkersMinimal-invasive surgeryRobotic surgery

Identifiers

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.