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Multicenter Study
. 2023 Apr 1;277(4):e839-e848.
doi: 10.1097/SLA.0000000000005530. Epub 2022 Jul 15.

Defining Global Benchmarks for Laparoscopic Liver Resections: An International Multicenter Study

Brian K P Goh  1 , Ho-Seong Han  2 , Kuo-Hsin Chen  3 , Darren W Chua  1 , Chung-Yip Chan  1 , Federica Cipriani  4 , Davit L Aghayan  5 , Asmund A Fretland  5 , Jasper Sijberden  6 , Mizelle D'Silva  2 , Tiing Foong Siow  3 , Yutaro Kato  7 , Chetana Lim  8 , Phan Phuoc Nghia  9 , Paulo Herman  10 , Marco V Marino  11   12 , Vincenzo Mazzaferro  13 , Adrian K H Chiow  14 , Iswanto Sucandy  15 , Arpad Ivanecz  16 , Sung Hoon Choi  17 , Jae Hoon Lee  18 , Mikel Gastaca  19 , Marco Vivarelli  20 , Felice Giuliante  21 , Andrea Ruzzenente  22 , Chee-Chien Yong  23 , Mengqui Yin  24 , Zewei Chen  24 , Constantino Fondevila  25   26 , Mikhail Efanov  27 , Fernando Rotellar  28   29 , Gi-Hong Choi  30 , Ricardo R Campos  31 , Xiaoying Wang  32 , Robert P Sutcliffe  33 , Johann Pratschke  34 , Eric Lai  35 , Charing C Chong  36 , Mathieu D'Hondt  37 , Kazuteru Monden  38 , Santiago Lopez-Ben  39 , Fabricio F Coelho  10 , Thomas Peter Kingham  40 , Rong Liu  41 , Tran Cong Duy Long  42 , Alessandro Ferrero  43 , Giovanni B Levi Sandri  44 , Mansour Saleh  45 , Daniel Cherqui  45 , Olivier Scatton  8 , Olivier Soubrane  46 , Go Wakabayashi  47 , Roberto I Troisi  48 , Tan-To Cheung  49 , Atsushi Sugioka  7 , Mohammad Abu Hilal  6   50 , David Fuks  46 , Bjørn Edwin  5 , Luca Aldrighetti  4 ; International Robotic and Laparoscopic Liver Resection Study Group Investigators
Collaborators, Affiliations
Free article
Multicenter Study

Defining Global Benchmarks for Laparoscopic Liver Resections: An International Multicenter Study

Brian K P Goh et al. Ann Surg. .
Free article

Abstract

Objective: To establish global benchmark outcomes indicators after laparoscopic liver resections (L-LR).

Background: There is limited published data to date on the best achievable outcomes after L-LR.

Methods: This is a post hoc analysis of a multicenter database of 11,983 patients undergoing L-LR in 45 international centers in 4 continents between 2015 and 2020. Three specific procedures: left lateral sectionectomy (LLS), left hepatectomy (LH), and right hepatectomy (RH) were selected to represent the 3 difficulty levels of L-LR. Fifteen outcome indicators were selected to establish benchmark cutoffs.

Results: There were 3519 L-LR (LLS, LH, RH) of which 1258 L-LR (40.6%) cases performed in 34 benchmark expert centers qualified as low-risk benchmark cases. These included 659 LLS (52.4%), 306 LH (24.3%), and 293 RH (23.3%). The benchmark outcomes established for operation time, open conversion rate, blood loss ≥500 mL, blood transfusion rate, postoperative morbidity, major morbidity, and 90-day mortality after LLS, LH, and RH were 209.5, 302, and 426 minutes; 2.1%, 13.4%, and 13.0%; 3.2%, 20%, and 47.1%; 0%, 7.1%, and 10.5%; 11.1%, 20%, and 50%; 0%, 7.1%, and 20%; and 0%, 0%, and 0%, respectively.

Conclusions: This study established the first global benchmark outcomes for L-LR in a large-scale international patient cohort. It provides an up-to-date reference regarding the "best achievable" results for L-LR for which centers adopting L-LR can use as a comparison to enable an objective assessment of performance gaps and learning curves.

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Conflict of interest statement

B.K.P.G. has received travel grants and honorarium from Johnson and Johnson, Olympus, and Transmedic the local distributor for the Da Vinci Robot. M.V.M. is a consultant for CAVA robotics LLC. J.P. reports a research grant from Intuitive Surgical Deutschland GmbH and personal fees or nonfinancial support from Johnson & Johnson, Medtronic, AFS Medical, Astellas, CHG Meridian, Chiesi, Falk Foundation, La Fource Group, Merck, Neovii, NOGGO, pharma-consult Peterson, and Promedicis. M.S. reports personal fees or other support outside of the submitted work from Merck, Bayer, ERBE, Amgen, Johnson & Johnson, Takeda, Olympus, Medtronic, and Intuitive. A.F. reports receiving speaker fees from Bayer. F.R. reports speaker fees and support outside the submitted work from Integra, Medtronic, Olympus, Corza, Sirtex, and Johnson & Johnson. The remaining authors report no conflicts of interest.

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