Lan X, Zhang HL, Zhang H, Peng YF, Liu F, Li B, Wei YG. Four-year experience with more than 1000 cases of total laparoscopic liver resection in a single center. World J Gastroenterol 2022; 28(25): 2968-2980 [PMID: 35978880 DOI: 10.3748/wjg.v28.i25.2968]
Corresponding Author of This Article
Yong-Gang Wei, MD, PhD, Professor, Surgeon, Department of Liver Surgery & Liver Transplantation Center, Sichuan University West China Hospital, No. 37 Guo Xue Road, Wuhou District, Chengdu 610041, Sichuan Province, China. docweiyonggang@163.com
Research Domain of This Article
Surgery
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Xiang Lan, Department of Hepatobiliary Surgery, The First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China
Hai-Li Zhang, Hua Zhang, Yu-Fu Peng, Fei Liu, Bo Li, Yong-Gang Wei, Department of Liver Surgery & Liver Transplantation Center, Sichuan University West China Hospital, Chengdu 610041, Sichuan Province, China
Author contributions: Lan X and Zhang HL contributed equally to this study and participated in the research design and preparation of the paper; Liu F, Zhang H and Zhang HL performed the statistical analysis; Li B revised this article and Wei YG performed the operation; all the authors contributed to this study.
Institutional review board statement: All clinical investigations were in accordance with the ethical guidelines of the Declaration of Helsinki. Ethical approval was obtained from the Committee of Ethics in West China Hospital of Sichuan University.
Informed consent statement: Written informed consent for surgery was obtained from both patient and her family in this study.
Conflict-of-interest statement: All the authors have no conflicts of interest or financial ties to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yong-Gang Wei, MD, PhD, Professor, Surgeon, Department of Liver Surgery & Liver Transplantation Center, Sichuan University West China Hospital, No. 37 Guo Xue Road, Wuhou District, Chengdu 610041, Sichuan Province, China. docweiyonggang@163.com
Received: January 4, 2022 Peer-review started: January 4, 2022 First decision: March 9, 2022 Revised: April 1, 2022 Accepted: May 27, 2022 Article in press: May 27, 2022 Published online: July 7, 2022
Abstract
BACKGROUND
Laparoscopic liver resection (LLR) has become a safe surgical procedure that needs additional summarization.
AIM
To review 4 years of total LLR surgeries, exceeding 1000 cases, which were performed at a single center.
METHODS
Patients who underwent LLR at West China Hospital of Sichuan University between January 2015 and December 2018 were identified. Surgical details, including the interventional year, category of liver disease, and malignant liver tumors prognosis, were evaluated. The learning curve for LLR was evaluated using the cumulative sum method. The Kaplan-Meier method was used to perform survival analysis.
RESULTS
Ultimately, 1098 patients were identified. Hepatocellular carcinoma (HCC) was the most common disease that led to the need for LLR at the center (n = 462, 42.08%). The average operation time was 216.94 ± 98.51 min. The conversion rate was 1.82% (20/1098). The complication rate was 9.20% (from grade II to V). The 1-year and 3-year overall survival rates of HCC patients were 89.7% and 81.9%, respectively. The learning curve was grouped into two phases for local resection (cases 1-106 and 107-373), three phases for anatomical segmentectomy (cases 1-44, 45-74 and 75-120), and three phases for hemihepatectomy (cases 1-17, 18-48 and 49-88).
CONCLUSION
LLR may be considered a first-line surgical intervention for liver resection that can be performed safely for a variety of primary, secondary, and recurrent liver tumors and for benign diseases once technical competence is proficiently attained.
Core Tip: West China Hospital of Sichuan University is the biggest and most advanced one in the western region of China. About 1500-2500 cases of liver resection have been performed in our center every year. Since the first laparoscopic liver resection (LLR) was performed in 2015, we have accumulated more than 1000 cases rapidly, including hemi-hepatectomy, mesohepatectomy, anatomical segmentectomy from segment I to VIII and even the first case of laparoscopic donor hepatectomy in Mainland China. In this study, we want to share our experiences and introduce technical innovation of LLR.
