Multicenter Study

. 2023 Feb;30(2):177-191.

doi: 10.1002/jhbp.1210. Epub 2022 Jul 20.

Comparison between the difficulty of laparoscopic limited liver resections of tumors located in segment 7 versus segment 8: An international multicenter propensity-score matched study

Mikhail Efanov¹, Diana Salimgereeva¹, Ruslan Alikhanov¹, Andrew G R Wu², David Geller³, Federica Cipriani⁴, Davit L Aghayan^{5

6}, Asmund Avdem Fretland^{5

6}, Jasper Sijberden⁷, Andrea Belli⁸, Marco V Marino⁹, Vincenzo Mazzaferro^{10

11}, Adrian K H Chiow¹², Iswanto Sucandy¹³, Arpad Ivanecz¹⁴, Sung Hoon Choi¹⁵, Jae Hoon Lee¹⁶, Mikel Prieto¹⁷, Marco Vivarelli¹⁸, Felice Giuliante¹⁹, Andrea Ruzzenente²⁰, Chee-Chien Yong²¹, Constantino Fondevila^{22

23}, Fernando Rotellar^{24

25}, Gi-Hong Choi²⁶, Ricardo Robless Campos²⁷, Xiaoying Wang²⁸, Robert P Sutcliffe²⁹, Johann Pratschke³⁰, Eric Lai³¹, Charing C Chong³², Mathieu D'Hondt³³, Kazuteru Monden³⁴, Santiago Lopez-Ben³⁵, Paulo Herman³⁶, Fabrizio Di Benedetto³⁷, T Peter Kingham³⁸, Rong Liu³⁹, Tran Cong Duy Long⁴⁰, Alessandro Ferrero⁴¹, Giovanni Battista Levi Sandri⁴², Daniel Cherqui⁴³, Olivier Scatton⁴⁴, Go Wakabayashi⁴⁵, Roberto I Troisi⁴⁶, Tan-To Cheung⁴⁷, Atsushi Sugioka⁴⁸, Ho-Seong Han⁴⁹, Mohammad Abu Hilal^{7

50}, Olivier Soubrane⁵¹, David Fuks⁵¹, Luca Aldrighetti⁴, Bjorn Edwin^{5

6}, Brian K P Goh⁵²; International Robotic and Laparoscopic Liver Resection Study Group Investigators

Collaborators, Affiliations

Collaborators

International Robotic and Laparoscopic Liver Resection Study Group Investigators:
Chung-Yip Chan, Nicholas Syn, Mizelle D'Silva, Boram Lee, Chetana Lim, Phan Phuoc Nghia, Mikel Gastaca, Henri Schotte, Celine De Meyere, Felix Krenzien, Moritz Schmelzle, Kit-Fai Lee, Lip Seng Lee, Jae Young Jang, Masayuki Kojima, Yutaro Kato, Jacob Ghotbi, Jaime Arthur Pirola Kruger, Fabricio Ferreira Coelho, Victor Lopez-Lopez, Bernardo Dalla Valle, Margarida Casellas I Robert, Kohei Mishima, Roberto Montalti, Mariano Giglio, Hao-Ping Wang, Franco Pascual, Mansour Saleh, Prashant Kadam, Chung-Ngai Tang, Francesco Ardito, Simone Vani, Ugo Giustizieri, Davide Citterio, Federico Mocchegiani, Giuseppe Maria Ettorre, Marco Colasanti, Yoelimar Guzmán, Epameinondas Dogeas, Paolo Magistri, Alessandro Mazzotta

Affiliations

¹ Department of Hepato-Pancreato-Biliary Surgery, Moscow Clinical Scientific Center, Moscow, Russia.
² Yong Loo Lin School of Medicine, National University of Singapore Medical School, Singapore City, Singapore.
³ Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
⁴ Hepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy.
⁵ The Intervention Centre and Department of HPB Surgery, Oslo University Hospital, Oslo, Norway.
⁶ Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
⁷ Department of Surgery, Fondazione Poliambulanza, Brescia, Italy.
⁸ Department of Abdominal Oncology, Division of Hepatopancreatobiliary Surgical Oncology, National Cancer Center - IRCCS-G. Pascale, Naples, Italy.
⁹ General Surgery Department, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy.
¹⁰ Oncologic Surgery Department, P. Giaccone University Hospital, Palermo, Italy.
¹¹ HPB Surgery and Liver Transplantation, Fondazione IRCCS Istituto Nazionale Tumori di Milano and University of Milan, Milan, Italy.
¹² Hepatopancreatobiliary Unit, Department of Surgery, Changi General Hospital, Singapore City, Singapore.
¹³ AdventHealth Tampa, Digestive Health Institute, Tampa, Florida, USA.
¹⁴ Department of Abdominal and General Surgery, University Medical Center Maribor, Maribor, Slovenia.
¹⁵ Department of General Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.
¹⁶ Department of Surgery, Division of Hepato-Biliary and Pancreatic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
¹⁷ Hepatobiliary Surgery and Liver Transplantation Unit, Biocruces Bizkaia Health Research Institute, Cruces University Hospital, University of the Basque Country, Bilbao, Spain.
¹⁸ HPB Surgery and Transplantation Unit, United Hospital of Ancona, Department of Sperimental and Clinical Medicine Polytechnic University of Marche, Ancona, Italy.
¹⁹ Hepatobiliary Surgery Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Catholic University of the Sacred Heart, Rome, Italy.
²⁰ General and Hepatobiliary Surgery, Department of Surgery, Dentistry, Gynecology and Pediatrics, University of Verona, GB Rossi Hospital, Verona, Italy.
²¹ Department of Surgery, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
²² General and Digestive Surgery, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain.
²³ General and Digestive Surgery, Hospital Clinic, IDIBAPS, CIBERehd, University of Barcelona, Barcelona, Spain.
²⁴ HPB and Liver Transplant Unit, Department of General Surgery, Clinica Universidad de Navarra, Universidad de Navarra, Pamplona, Spain.
²⁵ Institute of Health Research of Navarra (IdisNA), Pamplona, Spain.
²⁶ Division of Hepatopancreatobiliary Surgery, Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
²⁷ Department of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de la Arrixaca, IMIB-ARRIXACA, El Palmar, Spain.
²⁸ Department of Liver Surgery and Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China.
²⁹ Department of Hepatopancreatobiliary and Liver Transplant Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
³⁰ Department of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin, Corporate Member of Freie Universität Berlin, and Berlin Institute of Health, Berlin, Germany.
³¹ Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China.
³² Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.
³³ Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, Kortrijk, Belgium.
³⁴ Department of Surgery, Fukuyama City Hospital, Hiroshima, Japan.
³⁵ Hepatobiliary and Pancreatic Surgery Unit, Department of Surgery, Dr. Josep Trueta Hospital, IdIBGi, Girona, Spain.
³⁶ Liver Surgery Unit, Department of Gastroenterology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
³⁷ Hepatopancreatobiliary Surgery and Liver Transplant Unit, University of Modena and Reggio Emilia, Modena, Italy.
³⁸ Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
³⁹ Faculty of Hepatopancreatobiliary Surgery, The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
⁴⁰ HPB Surgery Department, University Medical Center, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.
⁴¹ Department of General and Oncological Surgery, Mauriziano Hospital, Turin, Italy.
⁴² Division of General Surgery and Liver Transplantation, S. Camillo Hospital, Rome, Italy.
⁴³ Department of Hepatobiliary Surgery, Assistance Publique Hopitaux de Paris, Centre Hepato-Biliaire, Paul-Brousse Hospital, Villejuif, France.
⁴⁴ Department of Digestive, HBP and Liver Transplantation, Hopital Pitie-Salpetriere, Sorbonne Universite, Paris, France.
⁴⁵ Center for Advanced Treatment of Hepatobiliary and Pancreatic Diseases, Ageo Central General Hospital, Saitama, Japan.
⁴⁶ Division of HPB, Minimally Invasive and Robotic Surgery, Department of Clinical Medicine and Surgery, Federico II University Hospital Naples, Naples, Italy.
⁴⁷ Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China.
⁴⁸ Department of Surgery, Fujita Health University School of Medicine, Aichi, Japan.
⁴⁹ Department of Surgery, Seoul National University Hospital Bundang, Seoul National University College of Medicine, Seoul, Korea.
⁵⁰ Department of Surgery, University Hospital Southampton, Southampton, UK.
⁵¹ Department of Digestive, Oncologic and Metabolic Surgery, Institute Mutualiste Montsouris, Universite Paris Descartes, Paris, France.
⁵² Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital/National Cancer Centre Singapore and Duke-National University of Singapore Medical School, Singapore City, Singapore.

PMID: 35758911
DOI: 10.1002/jhbp.1210

Multicenter Study

Comparison between the difficulty of laparoscopic limited liver resections of tumors located in segment 7 versus segment 8: An international multicenter propensity-score matched study

Mikhail Efanov et al. J Hepatobiliary Pancreat Sci. 2023 Feb.

. 2023 Feb;30(2):177-191.

doi: 10.1002/jhbp.1210. Epub 2022 Jul 20.

Authors

Collaborators

International Robotic and Laparoscopic Liver Resection Study Group Investigators:
Chung-Yip Chan, Nicholas Syn, Mizelle D'Silva, Boram Lee, Chetana Lim, Phan Phuoc Nghia, Mikel Gastaca, Henri Schotte, Celine De Meyere, Felix Krenzien, Moritz Schmelzle, Kit-Fai Lee, Lip Seng Lee, Jae Young Jang, Masayuki Kojima, Yutaro Kato, Jacob Ghotbi, Jaime Arthur Pirola Kruger, Fabricio Ferreira Coelho, Victor Lopez-Lopez, Bernardo Dalla Valle, Margarida Casellas I Robert, Kohei Mishima, Roberto Montalti, Mariano Giglio, Hao-Ping Wang, Franco Pascual, Mansour Saleh, Prashant Kadam, Chung-Ngai Tang, Francesco Ardito, Simone Vani, Ugo Giustizieri, Davide Citterio, Federico Mocchegiani, Giuseppe Maria Ettorre, Marco Colasanti, Yoelimar Guzmán, Epameinondas Dogeas, Paolo Magistri, Alessandro Mazzotta

Affiliations

¹ Department of Hepato-Pancreato-Biliary Surgery, Moscow Clinical Scientific Center, Moscow, Russia.
² Yong Loo Lin School of Medicine, National University of Singapore Medical School, Singapore City, Singapore.
³ Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
⁴ Hepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy.
⁵ The Intervention Centre and Department of HPB Surgery, Oslo University Hospital, Oslo, Norway.
⁶ Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
⁷ Department of Surgery, Fondazione Poliambulanza, Brescia, Italy.
⁸ Department of Abdominal Oncology, Division of Hepatopancreatobiliary Surgical Oncology, National Cancer Center - IRCCS-G. Pascale, Naples, Italy.
⁹ General Surgery Department, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy.
¹⁰ Oncologic Surgery Department, P. Giaccone University Hospital, Palermo, Italy.
¹¹ HPB Surgery and Liver Transplantation, Fondazione IRCCS Istituto Nazionale Tumori di Milano and University of Milan, Milan, Italy.
¹² Hepatopancreatobiliary Unit, Department of Surgery, Changi General Hospital, Singapore City, Singapore.
¹³ AdventHealth Tampa, Digestive Health Institute, Tampa, Florida, USA.
¹⁴ Department of Abdominal and General Surgery, University Medical Center Maribor, Maribor, Slovenia.
¹⁵ Department of General Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.
¹⁶ Department of Surgery, Division of Hepato-Biliary and Pancreatic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
¹⁷ Hepatobiliary Surgery and Liver Transplantation Unit, Biocruces Bizkaia Health Research Institute, Cruces University Hospital, University of the Basque Country, Bilbao, Spain.
¹⁸ HPB Surgery and Transplantation Unit, United Hospital of Ancona, Department of Sperimental and Clinical Medicine Polytechnic University of Marche, Ancona, Italy.
¹⁹ Hepatobiliary Surgery Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Catholic University of the Sacred Heart, Rome, Italy.
²⁰ General and Hepatobiliary Surgery, Department of Surgery, Dentistry, Gynecology and Pediatrics, University of Verona, GB Rossi Hospital, Verona, Italy.
²¹ Department of Surgery, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
²² General and Digestive Surgery, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain.
²³ General and Digestive Surgery, Hospital Clinic, IDIBAPS, CIBERehd, University of Barcelona, Barcelona, Spain.
²⁴ HPB and Liver Transplant Unit, Department of General Surgery, Clinica Universidad de Navarra, Universidad de Navarra, Pamplona, Spain.
²⁵ Institute of Health Research of Navarra (IdisNA), Pamplona, Spain.
²⁶ Division of Hepatopancreatobiliary Surgery, Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
²⁷ Department of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de la Arrixaca, IMIB-ARRIXACA, El Palmar, Spain.
²⁸ Department of Liver Surgery and Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China.
²⁹ Department of Hepatopancreatobiliary and Liver Transplant Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
³⁰ Department of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin, Corporate Member of Freie Universität Berlin, and Berlin Institute of Health, Berlin, Germany.
³¹ Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China.
³² Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.
³³ Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, Kortrijk, Belgium.
³⁴ Department of Surgery, Fukuyama City Hospital, Hiroshima, Japan.
³⁵ Hepatobiliary and Pancreatic Surgery Unit, Department of Surgery, Dr. Josep Trueta Hospital, IdIBGi, Girona, Spain.
³⁶ Liver Surgery Unit, Department of Gastroenterology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
³⁷ Hepatopancreatobiliary Surgery and Liver Transplant Unit, University of Modena and Reggio Emilia, Modena, Italy.
³⁸ Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
³⁹ Faculty of Hepatopancreatobiliary Surgery, The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
⁴⁰ HPB Surgery Department, University Medical Center, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.
⁴¹ Department of General and Oncological Surgery, Mauriziano Hospital, Turin, Italy.
⁴² Division of General Surgery and Liver Transplantation, S. Camillo Hospital, Rome, Italy.
⁴³ Department of Hepatobiliary Surgery, Assistance Publique Hopitaux de Paris, Centre Hepato-Biliaire, Paul-Brousse Hospital, Villejuif, France.
⁴⁴ Department of Digestive, HBP and Liver Transplantation, Hopital Pitie-Salpetriere, Sorbonne Universite, Paris, France.
⁴⁵ Center for Advanced Treatment of Hepatobiliary and Pancreatic Diseases, Ageo Central General Hospital, Saitama, Japan.
⁴⁶ Division of HPB, Minimally Invasive and Robotic Surgery, Department of Clinical Medicine and Surgery, Federico II University Hospital Naples, Naples, Italy.
⁴⁷ Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China.
⁴⁸ Department of Surgery, Fujita Health University School of Medicine, Aichi, Japan.
⁴⁹ Department of Surgery, Seoul National University Hospital Bundang, Seoul National University College of Medicine, Seoul, Korea.
⁵⁰ Department of Surgery, University Hospital Southampton, Southampton, UK.
⁵¹ Department of Digestive, Oncologic and Metabolic Surgery, Institute Mutualiste Montsouris, Universite Paris Descartes, Paris, France.
⁵² Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital/National Cancer Centre Singapore and Duke-National University of Singapore Medical School, Singapore City, Singapore.

PMID: 35758911
DOI: 10.1002/jhbp.1210

Abstract

Background: Presently, according to different difficulty scoring systems, there is no difference in complexity estimation of laparoscopic liver resection (LLR) of segments 7 and 8. However, there is no published data supporting this assumption. To date, no studies have compared the outcomes of laparoscopic parenchyma-sparing resection of the liver segments 7 and 8.

Methods: A post hoc analysis of patients undergoing LLR of segments 7 and 8 in 46 centers between 2004 and 2020 was performed. 1:1 Propensity score matching (PSM) was used to compare isolated LLR of segments 7 and 8. Subset analyses were also performed to compare atypical resections and segmentectomies of 7 and 8.

Results: A total of 2411 patients were identified, and 1691 patients met the inclusion criteria. Comparison after PSM between the entire cohort of segment 7 and segment 8 resections revealed inferior results for segment 7 resection in terms of increased blood loss, blood transfusions, and conversions to open surgery. Subset analyses of only atypical resections similarly demonstrated poorer outcomes for segment 7 in terms of increased blood loss, operation time, blood transfusions, and conversions to open surgery. Conversely, a subgroup analysis of segmentectomies after PSM found better outcomes for segment 7 in terms of a shorter operation time and hospital stay.

Conclusion: Differences in the outcomes of segments 7 and 8 resections suggest a greater difficulty of laparoscopic atypical resection of segment 7 compared to segment 8, and greater difficulty of segmentectomy 8 compared to segmentectomy 7.

Keywords: hepatectomy; laparoscopy; liver resection; posterosuperior segments; risk score.

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Comparison between the difficulty of laparoscopic limited liver resections of tumors located in segment 7 versus segment 8: An international multicenter propensity-score matched study

Collaborators

Affiliations

Comparison between the difficulty of laparoscopic limited liver resections of tumors located in segment 7 versus segment 8: An international multicenter propensity-score matched study

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Abstract

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