Comparing indications, complexity and outcomes of laparoscopic liver resection between centers with and without a liver transplant program: a French nationwide study.

Journal

HPB : the official journal of the International Hepato Pancreato Biliary Association

ISSN: 1477-2574

Titre abrégé: HPB (Oxford)

Pays: England

ID NLM: 100900921

Informations de publication

Date de publication:
25 Jan 2024

Historique:

received: 14 12 2023

revised: 17 01 2024

accepted: 22 01 2024

medline: 11 2 2024

pubmed: 11 2 2024

entrez: 10 2 2024

Statut: aheadofprint

Résumé

There are no data to evaluate the difference in populations and impact of centers with liver transplant programs in performing laparoscopic liver resection (LLR). This was a multicenter study including patients undergoing LLR for benign and malignant tumors at 27 French centers from 1996 to 2018. The main outcomes were postoperative severe morbidity and mortality. A total of 3154 patients were included, and 14 centers were classified as transplant centers (N = 2167 patients, 68.7 %). The transplant centers performed more difficult LLRs and more resections for hepatocellular carcinoma (HCC) in patients who more frequently had cirrhosis. A higher rate of performing the Pringle maneuver, a lower rate of blood loss and a higher rate of open conversion (all p < 0.05) were observed in the transplant centers. There was no association between the presence of a liver transplant program and either postoperative severe morbidity (<10 % in each group; p = 0.228) or mortality (1 % in each group; p = 0.915). Most HCCs, difficult LLRs, and cirrhotic patients are treated in transplant centers. We show that all centers can achieve comparable safety and quality of care in LLR independent of the presence of a liver transplant program.

Sections du résumé

BACKGROUND BACKGROUND

There are no data to evaluate the difference in populations and impact of centers with liver transplant programs in performing laparoscopic liver resection (LLR).

METHODS METHODS

This was a multicenter study including patients undergoing LLR for benign and malignant tumors at 27 French centers from 1996 to 2018. The main outcomes were postoperative severe morbidity and mortality.

RESULTS RESULTS

A total of 3154 patients were included, and 14 centers were classified as transplant centers (N = 2167 patients, 68.7 %). The transplant centers performed more difficult LLRs and more resections for hepatocellular carcinoma (HCC) in patients who more frequently had cirrhosis. A higher rate of performing the Pringle maneuver, a lower rate of blood loss and a higher rate of open conversion (all p < 0.05) were observed in the transplant centers. There was no association between the presence of a liver transplant program and either postoperative severe morbidity (<10 % in each group; p = 0.228) or mortality (1 % in each group; p = 0.915).

CONCLUSIONS CONCLUSIONS

Most HCCs, difficult LLRs, and cirrhotic patients are treated in transplant centers. We show that all centers can achieve comparable safety and quality of care in LLR independent of the presence of a liver transplant program.

Identifiants

DOI: 10.1016/j.hpb.2024.01.010 PMID: 38341287

pubmed: 38341287

pii: S1365-182X(24)00012-1

doi: 10.1016/j.hpb.2024.01.010

pii:

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Investigateurs

Francois Cauchy (F)

Takeo Nomi (T)

Nassima Oudafal (N)

Brice Gayet (B)

Takayuki Kawai (T)

Shohei Komatsu (S)

Shinya Okumura (S)

Nicolo Petrucciani (N)

Petru Bucur (P)

Boris Trechot (B)

Julio Nunez (J)

Michele Tedeschi (M)

Marc-Antoine Allard (MA)

Nicolas Golse (N)

Oriana Ciacio (O)

Gabriella Pittau (G)

Antonio S Cunha (AS)

Rene Adam (R)

Christophe Laurent (C)

Pauline Leourier (P)

Lionel Rebibo (L)

Lorenzo Ferre (L)

Francois-Regis Souche (FR)

John Chauvat (J)

Francois Jehaes (F)

Kayvan Mohkam (K)

Thevy Hor (T)

Francois Paye (F)

Pierre Balladur (P)

Bertrand Suc (B)

Guillaume Millet (G)

Mehdi El Amrani (ME)

Celine Ratajczak (C)

Katia Lecolle (K)

Francois-Rene Pruvot (FR)

Ali-Reza Kianmanesh (AR)

Tatiana Codjia (T)

Lilian Schwarz (L)

Edouard Girard (E)

Julio Abba (J)

Christian Letoublon (C)

Ahmed F Bouras (AF)

Antoine Carmelo (A)

Charles VanBrugghe (C)

Zineb Cherkaoui (Z)

Xavier Unterteiner (X)

Patrick Pessaux (P)

Riccardo Memeo (R)

Emilie Lhermite (E)

Marie Bougard (M)

Julien Barbieux (J)

Ugo Marchese (U)

Jacques Ewald (J)

Olivier Turini (O)

Alexandre Thobie (A)

Benjamin Menahem (B)

Andrea Mulliri (A)

Jean Lubrano (J)

Johanna Zemour (J)

Herve Fagot (H)

Guillaume Passot (G)

Emilie Gregoire (E)

Yves P le Treut (YP)

David Patrice (D)