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Objective: Laparoscopic hepatectomy (LH) has become a common surgery for the treatment of liver tumor. To evaluate the surgical quality of laparoscopic hepatectomy under the context of precision surgery with Textbook outcome (TO), a comprehensive and holistic assessment approach.
Methods: A total of 1056 patients who underwent laparoscopic hepatectomy from May 2016 and December 2022 were enrolled in the study. All the patients were performed hepatectomy. The rate of TO and factors associated with achieving TO were examined.
Results: Among the 1056 patients, 75 % patients achieved TO. The main reason limited patients achieving textbook outcomes was prolonged length of hospital stay (LOS). The univariate analysis indicated that age>65, ASA classification ≥3, liver cirrhosis, tumor size > 3 cm, tumor number ≥2, type of primary cancer, and IWATE DSS were significantly associated with non-achievement of TO. The multivariate analysis indicated that the ASA classification ≥3 and advanced difficulty level in IWATE DSS independent factors associated with achieving TO. Reaching TO can significantly prolong the postoperative recurrence time and overall survival time of hepatocellular carcinoma patients.
Conclusion: In the context of precision surgery, 75 % patients undergoing laparoscopic hepatectomy achieved a TO. Patients who achieved TO had significantly improved survival.
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http://dx.doi.org/10.1016/j.dld.2024.04.016 | DOI Listing |
Ann Surg Oncol
September 2025
Carle Illinois College of Medicine University of Illinois Urbana-Champaign, 509 W University Ave, Urbana, IL, 61801, USA.
Background: The liver cone unit (Tokyo 2020 terminology) of the peripheral portal vein territory represents the smallest anatomical and functional unit of the liver. While this unit enables anatomical, subsegmental resection, particularly in patients with cirrhosis, the tumor-bearing cone unit can be challenging to identify intraoperatively. PATIENTS AND METHODS: A 58-year-old man with hepatitis C-related cirrhosis (Child-Pugh B) was diagnosed with a subcapsular hepatocellular carcinoma (HCC) in segment 8.
View Article and Find Full Text PDFEur J Surg Oncol
July 2025
General Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, PISA, Italy.
Introduction: Surgery for resectable gallbladder cancer (GbC) encompasses complex operative management, and evaluating surgical quality through textbook outcome (TO) is crucial. This study aimed to assess TO incidence and impact in a global cohort, identify independent predictors, and evaluate TO rates of minimally invasive (MI) techniques, including robotic (ROB) and laparoscopic (LPS).
Materials And Methods: This cohort study included patients undergoing curative-intent hepatectomy and lymphadenectomy for GbC (T1b-T3) from 2012 to 2023 in 41 hospitals.
Chirurgie (Heidelb)
September 2025
Chirurgische Klinik der Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland.
Background: Minimally invasive liver surgery has rapidly evolved in recent years. In addition to the laparoscopic liver resection (LLR), robot-assisted liver resection (RLR) is increasingly gaining in importance; however, although the robotic-assisted approach offers clinical benefits, particularly in complex procedures, it remains a matter of debate.
Objective: The aim of this study was to present the development, perioperative outcomes, key challenges, and insights from over 500 minimally invasive liver resections performed at a specialized high-volume center.
DEN Open
April 2026
Department of Gastroenterological Surgery, Ibaraki Medical Center Tokyo Medical University Ibaraki Japan.
Background: We investigated whether the standardized "can-opener method" surgical technique is an adequate surgical procedure for hemispheric hepatectomy in segments 7 and 8.
Methods: Forty-two patients who underwent laparoscopic hemispheric liver resection for segments 7 and 8 using our standardized surgical technique were enrolled. To examine the effect of this standardized surgical procedure on short-term outcomes, patients were classified into two groups based on the timing of the standardization of their procedures (Group A, the first half of the cases, and Group B, the second half of the cases).
Ann Med
December 2025
Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong, China.
Background: Thrombocytopenia (TCP) and coagulation disorders are common complications for patients with liver cirrhosis. The impact of severe TCP [30 × 10/L < platelets (PLT) ≤ 50 × 10/L] and coagulation disorder on bleeding risk after Hassab's operation or partial hepatectomy (PH) for cirrhotic patients is unclear.
Method: Our study retrospectively enrolled 724 cirrhotic patients from July 2019 to August 2024, including 189 patients who underwent Hassab's operation and 535 patients with hepatocellular carcinoma who underwent PH without prophylactic platelet transfusions or thrombopoietin receptor agonists.