• J. Am. Coll. Surg. · Oct 2024

    Multicenter Study

    Global Outcomes Benchmarks in Laparoscopic Liver Surgery for Segments 7 and 8: International Multicenter Analysis.

    • Victor Lopez-Lopez, Zeniche Morise, Concepción Gomez Gavara, Daniel Gero, Mohammed Abu Hilal, Brian Kp Goh, Paulo Herman, Pierre-Alain Clavien, Ricardo Robles-Campos, Go Wakabayashi, and Laparoscopic Liver Surgery Multicenter Study Group.
    • From the Department of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de La Arrixaca, IMIB-ARRIXACA, Murcia, Spain (Lopez-Lopez, Robles-Campos).
    • J. Am. Coll. Surg. 2024 Oct 1; 239 (4): 375386375-386.

    BackgroundIn recent years, there has been growing interest in laparoscopic liver resection (LLR) and the audit of the results of surgical procedures. The aim of this study was to define reference values for LLR in segments 7 and 8.Study DesignData on LLR in segments 7 and 8 between January 2000 and December 2020 were collected from 19 expert centers. Reference cases were defined as no previous hepatectomy, American Society of Anesthesiologists score less than 3, BMI less than 35 kg/m 2 , no chronic kidney disease, no cirrhosis and portal hypertension, no COPD (forced expiratory volume 1 <80%), and no cardiac disease. Reference values were obtained from the 75th percentile of the medians of all reference centers.ResultsOf 585 patients, 461 (78.8%) met the reference criteria. The overall complication rate was 27.5% (6% were Clavien-Dindo 3a or more) with a mean Comprehensive Complication Index of 7.5 ± 16.5. At 90-day follow-up, the reference values for overall complication were 31%, Clavien-Dindo 3a or more was 7.4%, conversion was 4.4%, hospital stay was less than 6 days, and readmission rate was <8.33%. Patients from Eastern centers categorized as low risk had a lower rate of overall complication (20.9% vs 31.2%, p = 0.01) with similar Clavien-Dindo 3a or more (5.5% and 4.8%, p = 0.83) compared with patients from Western centers, respectively.ConclusionsThis study shows the need to establish standards for the postoperative outcomes in LLR based on the complexity of the resection and the location of the lesions.Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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