Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
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 Efanov  1 , Diana Salimgereeva  1 , Ruslan Alikhanov  1 , Andrew G R Wu  2 , David Geller  3 , Federica Cipriani  4 , Davit L Aghayan  5   6 , Asmund Avdem Fretland  5   6 , Jasper Sijberden  7 , Andrea Belli  8 , Marco V Marino  9 , Vincenzo Mazzaferro  10   11 , Adrian K H Chiow  12 , Iswanto Sucandy  13 , Arpad Ivanecz  14 , Sung Hoon Choi  15 , Jae Hoon Lee  16 , Mikel Prieto  17 , Marco Vivarelli  18 , Felice Giuliante  19 , Andrea Ruzzenente  20 , Chee-Chien Yong  21 , Constantino Fondevila  22   23 , Fernando Rotellar  24   25 , Gi-Hong Choi  26 , Ricardo Robless Campos  27 , Xiaoying Wang  28 , Robert P Sutcliffe  29 , Johann Pratschke  30 , Eric Lai  31 , Charing C Chong  32 , Mathieu D'Hondt  33 , Kazuteru Monden  34 , Santiago Lopez-Ben  35 , Paulo Herman  36 , Fabrizio Di Benedetto  37 , T Peter Kingham  38 , Rong Liu  39 , Tran Cong Duy Long  40 , Alessandro Ferrero  41 , Giovanni Battista Levi Sandri  42 , Daniel Cherqui  43 , Olivier Scatton  44 , Go Wakabayashi  45 , Roberto I Troisi  46 , Tan-To Cheung  47 , Atsushi Sugioka  48 , Ho-Seong Han  49 , Mohammad Abu Hilal  7   50 , Olivier Soubrane  51 , David Fuks  51 , Luca Aldrighetti  4 , Bjorn Edwin  5   6 , Brian K P Goh  52 ; International Robotic and Laparoscopic Liver Resection Study Group Investigators
Collaborators, Affiliations
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.

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.

PubMed Disclaimer

References

REFERENCES

    1. Buell JF, Cherqui D, Geller DA, O'Rourke N, Iannitti D, Dagher I, et al. The international position on laparoscopic liver surgery: the Louisville Statement, 2008. Ann Surg. 2009;250:825-30.
    1. Wakabayashi G, Cherqui D, Geller DA, Buell JF, Kaneko H, Han HS, et al. Recommendations for laparoscopic liver resection: a report from the second international consensus conference held in Morioka. Ann Surg. 2015;261(4):619-29.
    1. Abu Hilal M, Aldrighetti L, Dagher I, Edwin B, Troisi RI, Alikhanov R, et al. The Southampton Consensus guidelines for laparoscopic liver surgery from indication to implementation. Ann Surg. 2018;268(1):11-8. https://doi.org/10.1097/SLA.0000000000002524
    1. Wakabayshi G. What has changed after the Morioka consensus conference 2014 on laparoscopic liver resection? Hepatobiliary Surg Nutr. 2016;5(4):281-9.
    1. Kawaguchi Y, Fuks D, Kokudo N, Gayet B. Difficulty of laparoscopic liver resection: proposal for a new classification. Ann Surg. 2018;267(1):13-7.

Publication types

LinkOut - more resources