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
ARTICLE HIGHLIGHTS
Research background
Laparoscopic liver resection (LLR) has become a safe approach but still need to be further summarized.
Research motivation
The present study reviews the 4-year experience of total LLR in a single center, which exceeded 1000 cases.
Research objectives
Summarize the past, in order to obtain better progress in this technology in the future.
Research methods
Patients who underwent LLR at West China Hospital of Sichuan University between January 2015 and December 2018 were identified. Surgical details in different years, categories of liver disease and prognosis of malignant liver tumors were evaluated. The learning curve for LLR was evaluated using the cumulative sum method. The Kaplan-Meier method was used to perform survival analysis.
Research results
Ultimately, 1098 patients were identified. Hepatocellular carcinoma (HCC) was the most common disease that led to the need for LLR in our center (n = 462, 42.08%). The average operation time was 216.94 min ± 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 hemi-hepatectomy (cases 1-17, 18-48 and 49-88).
Research conclusions
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.
Research perspectives
It is a very promising surgical procedure that can give patients a faster recovery time.
