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1. Are physical performance and frailty assessments useful in targeting and improving access to adjuvant therapy in patients undergoing resection for pancreatic cancer?

Author: Powell-Brett, S., Hodson, J., Pande, R., Mann, S., Freer, Alice, Wyrko, Zoe, Hughes, Clare, Isaac, J., Sutcliffe, R. P., and Roberts, K.
Published: 2023
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2. Impact of Frailty on Short-Term Outcomes After Laparoscopic and Open Hepatectomy

Author: Osei-Bordom, D., Hall, L., Hodson, J., Joshi, K., Austen, L., Bartlett, D., Isaac, J., Mirza, D. F., Marudanayagam, R., Roberts, K., Dasari, B. V., Chatzizacharias, N., and Sutcliffe, R. P.
Published: 2022
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3. Dragon 1 Protocol Manuscript: Training, Accreditation, Implementation and Safety Evaluation of Portal and Hepatic Vein Embolization (PVE/HVE) to Accelerate Future Liver Remnant (FLR) Hypertrophy

Author: Korenblik, R., Olij, B., Aldrighetti, L. A., Hilal, M. Abu, Ahle, M., Arslan, B., van Baardewijk, L. J., Baclija, I., Bent, C., Bertrand, C. L., Björnsson, B., de Boer, M. T., de Boer, S. W., Bokkers, R. P. H., Rinkes, I. H. M. Borel, Breitenstein, S., Bruijnen, R. C. G., Bruners, P., Büchler, M. W., Camacho, J. C., Cappelli, A., Carling, U., Chan, B. K. Y., Chang, D. H., choi, J., Font, J. Codina, Crawford, M., Croagh, D., Cugat, E., Davis, R., De Boo, D. W., De Cobelli, F., De Wispelaere, J. F., van Delden, O. M., Delle, M., Detry, O., Díaz-Nieto, R., Dili, A., Erdmann, J. I., Fisher, O., Fondevila, C., Fretland, Å., Borobia, F. Garcia, Gelabert, A., Gérard, L., Giuliante, F., Gobardhan, P. D., Gómez, F., Grünberger, T., Grünhagen, D. J., Guitart, J., Hagendoorn, J., Heil, J., Heise, D., Herrero, E., Hess, G. F., Hoffmann, M. H., Iezzi, R., Imani, F., Nguyen, J., Jovine, E., Kalff, J. C., Kazemier, G., Kingham, T. P., Kleeff, J., Kollmar, O., Leclercq, W. K. G., Ben, S. Lopez, Lucidi, V., MacDonald, A., Madoff, D. C., Manekeller, S., Martel, G., Mehrabi, A., Mehrzad, H., Meijerink, M. R., Menon, K., Metrakos, P., Meyer, C., Moelker, A., Modi, S., Montanari, N., Navines, J., Neumann, U. P., Peddu, P., Primrose, J. N., Qu, X., Raptis, D., Ratti, F., Ridouani, F., Rogan, C., Ronellenfitsch, U., Ryan, S., Sallemi, C., Moragues, J. Sampere, Sandström, P., Sarriá, L., Schnitzbauer, A., Serenari, M., Serrablo, A., Smits, M. L. J., Sparrelid, E., Spüntrup, E., Stavrou, G. A., Sutcliffe, R. P., Tancredi, I., Tasse, J. C., Udupa, V., Valenti, D., Fundora, Y., Vogl, T. J., Wang, X., White, S. A., Wohlgemuth, W. A., Yu, D., Zijlstra, I. A. J., Binkert, C. A., Bemelmans, M. H. A., van der Leij, C., Schadde, E., and van Dam, R. M.
Published: 2022
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4. Comparative Volumetric Analysis of Hermes and Synapse Software Systems in the Setting of Liver Surgery

Author: Joshi, K., Nutu, A., Wilson, M., Marudanayagam, R., Isaac, J., Sutcliffe, R. P., and Dasari, B. V. M.
Published: 2022
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5. Are enhanced recovery protocols after pancreatoduodenectomy still efficient when applied in elderly patients? A systematic review and individual patient data meta-analysis

Author: Kuemmerli, C, Balzano, G, Bouwense, S, Braga, M, Coolsen, M, Daniel, S, Dervenis, C, Falconi, M, Hwang, D, Kagedan, D, Kim, S, Lavu, H, Nussbaum, D, Partelli, S, Passeri, M, Pecorelli, N, Pillarisetty, V, Pucci, M, Sutcliffe, R, Tingstedt, B, van der Kolk, M, Vrochides, D, Armstrong, M, Wei, A, Williamsson, C, Yeo, C, Zani, S, Zouros, E, Rozzini, R, Abuhilal, M, Kuemmerli C., Balzano G., Bouwense S. A., Braga M., Coolsen M., Daniel S. K., Dervenis C., Falconi M., Hwang D. W., Kagedan D. J., Kim S. C., Lavu H., Nussbaum D., Partelli S., Passeri M. J., Pecorelli N., Pillarisetty V. G., Pucci M. J., Sutcliffe R. P., Tingstedt B., van der Kolk M., Vrochides D., Armstrong M., Wei A., Williamsson C., Yeo C. J., Zani S., Zouros E., Rozzini R., AbuHilal M., Kuemmerli, C, Balzano, G, Bouwense, S, Braga, M, Coolsen, M, Daniel, S, Dervenis, C, Falconi, M, Hwang, D, Kagedan, D, Kim, S, Lavu, H, Nussbaum, D, Partelli, S, Passeri, M, Pecorelli, N, Pillarisetty, V, Pucci, M, Sutcliffe, R, Tingstedt, B, van der Kolk, M, Vrochides, D, Armstrong, M, Wei, A, Williamsson, C, Yeo, C, Zani, S, Zouros, E, Rozzini, R, Abuhilal, M, Kuemmerli C., Balzano G., Bouwense S. A., Braga M., Coolsen M., Daniel S. K., Dervenis C., Falconi M., Hwang D. W., Kagedan D. J., Kim S. C., Lavu H., Nussbaum D., Partelli S., Passeri M. J., Pecorelli N., Pillarisetty V. G., Pucci M. J., Sutcliffe R. P., Tingstedt B., van der Kolk M., Vrochides D., Armstrong M., Wei A., Williamsson C., Yeo C. J., Zani S., Zouros E., Rozzini R., and AbuHilal M.
Abstract: Background: This meta-analysis investigated the effects of enhanced recovery after surgery (ERAS) protocols compared to conventional care on postoperative outcomes in patients aged 70 years or older undergoing pancreatoduodenectomy (PD). Methods: Five databases were systematically searched. Comparative studies with available individual patient data (IPD) were included. The main outcomes were postoperative morbidity, length of stay, readmission and postoperative functional recovery elements. To assess an age-dependent effect, the group was divided in septuagenarians (70–79 years) and older patients (≥80 years). Results: IPD were obtained from 15 of 31 eligible studies comprising 1109 patients. The overall complication and major complication rates were comparable in both groups (OR 0.92 [95% CI: 0.65–1.29], p =.596 and OR 1.22 [95% CI: 0.61–2.46], p =.508). Length of hospital stay tended to be shorter in the ERAS group compared to the conventional care group (−0.14 days [95% CI: −0.29 to 0.01], p =.071) while readmission rates were comparable and the total length of stay including days in hospital after readmission tended to be shorter in the ERAS group (−0.28 days [95% CI: −0.62 to 0.05], p =.069). In the subgroups, the length of stay was shorter in octogenarians treated with ERAS (−0.36 days [95% CI: −0.71 to −0.004], p =.048). The readmission rate increased slightly but not significantly while the total length of stay was not longer in the ERAS group. Conclusion: ERAS in the elderly is safe and its benefits are preserved in the care of even in patients older than 80 years. Standardized care protocol should be encouraged in all pancreatic centers.
Published: 2024

6. Robotic Versus Laparoscopic Left and Extended Left Hepatectomy: An International Multicenter Study Propensity Score-Matched Analysis

Author: Sucandy I., Rayman S., Lai E. C., Tang C. -N., Chong Y., Efanov M., Fuks D., Choi G. -H., Chong C. C., Chiow A. K. H., Marino M. V., Prieto M., Lee J. -H., Kingham T. P., D'Hondt M., Troisi R. I., Choi S. H., Sutcliffe R. P., Cheung T. -T., Rotellar F., Park J. O., Scatton O., Han H. -S., Pratschke J., Wang X., Liu R., Goh B. K. P., Chan C. -Y., D'Silva M., Schotte H., De Meyere C., Krenzien F., Schmelzle M., Kadam P., Montalti R., Liu Q., Lee K. -F., Salimgereeva D., Alikhanov R., Lee L. S., Gastaca M., Jang J. Y., Lim C., Labadie K. P., Sucandy, I., Rayman, S., Lai, E. C., Tang, C. -N., Chong, Y., Efanov, M., Fuks, D., Choi, G. -H., Chong, C. C., Chiow, A. K. H., Marino, M. V., Prieto, M., Lee, J. -H., Kingham, T. P., D'Hondt, M., Troisi, R. I., Choi, S. H., Sutcliffe, R. P., Cheung, T. -T., Rotellar, F., Park, J. O., Scatton, O., Han, H. -S., Pratschke, J., Wang, X., Liu, R., Goh, B. K. P., Chan, C. -Y., D'Silva, M., Schotte, H., De Meyere, C., Krenzien, F., Schmelzle, M., Kadam, P., Montalti, R., Liu, Q., Lee, K. -F., Salimgereeva, D., Alikhanov, R., Lee, L. S., Gastaca, M., Jang, J. Y., Lim, C., and Labadie, K. P.
Subjects: Oncology, Surgery
Abstract: Background: Controversies exist among liver surgeons regarding clinical outcomes of the laparoscopic versus the robotic approach for major complex hepatectomies. The authors therefore designed a study to examine and compare the perioperative outcomes of laparoscopic left hepatectomy or extended left hepatectomy (L-LH/L-ELH) versus robotic left hepatectomy or extended left hepatectomy (R-LH/R-ELH) using a large international multicenter collaborative database. Methods: An international multicenter retrospective analysis of 580 patients undergoing L-LH/L-ELH or R-LH/R-ELH at 25 specialized hepatobiliary centers worldwide was undertaken. Propensity score-matching (PSM) was used at a 1:1 nearest-neighbor ratio according to 15 perioperative variables, including demographics, tumor characteristics, Child-Pugh score, presence of portal hypertension, multiple resections, histologic diagnosis, and Iwate difficulty grade. Results: Before the PSM, 190 (32 %) patients underwent R-LH/R-ELH, and 390 (68 %) patients underwent L-LH/L-ELH. After the matching, 164 patients were identified in each arm without significant differences in demographics, preoperative variables, medical history, tumor pathology, tumor characteristics, or Iwate score. Regarding intra- and postoperative outcomes, the rebotic approach had significantly less estimated blood loss (EBL) (100 ml [IQR 200 ml] vs 200 ml [IQR 235 ml]; p = 0.029), fewer conversions to open operations (n = 4 [2.4 %] vs n = 13, [7.9 %]; p = 0.043), and a shorter hospital stay (6 days [IQR 3 days] vs 7 days [IQR 3.3 days]; p = 0.009). Conclusion: Both techniques are safe and feasible in major hepatic resections. Compared with L-LH/L-ELH, R-LH/R-ELH is associated with less EBL, fewer conversions to open operations, and a shorter hospital stay.
Published: 2022

7. Significance of predicted future liver remnant volume on liver failure risk after major hepatectomy: a case matched comparative study

Author: Piccus, R., primary, Joshi, K., additional, Hodson, J., additional, Bartlett, D., additional, Chatzizacharias, N., additional, Dasari, B., additional, Isaac, J., additional, Marudanayagam, R., additional, Mirza, D. F., additional, Roberts, J. K., additional, and Sutcliffe, R. P., additional
Published: 2023
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8. ASO Author Reflections: The Robotic Versus Laparoscopic Approach to Left and Extended Left Hepatectomy

Author: Rayman S., Jacoby H., Sucandy I., Goh B. K. P., Chan C. -Y., Han H. -S., D'Silva M., D'Hondt M., Schotte H., De Meyere C., Krenzien F., Schmelzle M., Pratschke J., Sutcliffe R. P., Kadam P., Troisi R. I., Giglio M., Montalti R., Liu R., Liu Q., Chong C. C., Lee K. -F., Efanov M., Salimgereeva D., Alikhanov R., Chiow A. K. H., Lee L. S., Prieto M., Gastaca M., Choi S. -H., Jang J. Y., Scatton O., Lim C., Park J. O., Labadie K. P., Lai E. C., Tang C. -N., Wang X., Chong Y., Fuks D., Choi G. -H., Marino M. V., Lee J. H., Kingham T. P., Cheung T. -T., Rotellar F., Rayman, S., Jacoby, H., Sucandy, I., Goh, B. K. P., Chan, C. -Y., Han, H. -S., D'Silva, M., D'Hondt, M., Schotte, H., De Meyere, C., Krenzien, F., Schmelzle, M., Pratschke, J., Sutcliffe, R. P., Kadam, P., Troisi, R. I., Giglio, M., Montalti, R., Liu, R., Liu, Q., Chong, C. C., Lee, K. -F., Efanov, M., Salimgereeva, D., Alikhanov, R., Chiow, A. K. H., Lee, L. S., Prieto, M., Gastaca, M., Choi, S. -H., Jang, J. Y., Scatton, O., Lim, C., Park, J. O., Labadie, K. P., Lai, E. C., Tang, C. -N., Wang, X., Chong, Y., Fuks, D., Choi, G. -H., Marino, M. V., Lee, J. H., Kingham, T. P., Cheung, T. -T., and Rotellar, F.
Subjects: Oncology, Surgery
Published: 2022

9. Impact of neoadjuvant chemotherapy on the difficulty and outcomes of laparoscopic and robotic major liver resections for colorectal liver metastases: A propensity-score and coarsened exact-matched controlled study

Author: Ghotbi, J., Aghayan, D., Fretland, A., Edwin, B., Syn, N. L., Cipriani, F., Alzoubi, M., Lim, C., Scatton, O., Long, T. C. D., Herman, P., Coelho, F. F., Marino, M. V., Mazzaferro, V., Chiow, A. K. H., Sucandy, I., Ivanecz, A., Choi, S. -H., Lee, J. H., Prieto, M., Vivarelli, M., Giuliante, Felice, Ruzzenente, A., Yong, C. -C., Yin, M., Fondevila, C., Efanov, M., Morise, Z., Di Benedetto, F., Brustia, R., Dalla Valle, R., Boggi, U., Geller, D., Belli, A., Memeo, R., Mejia, A., Park, J. O., Rotellar, F., Choi, G. -H., Robles-Campos, R., Wang, X., Sutcliffe, R. P., Pratschke, J., Tang, C. -N., Chong, C. C. N., D'Hondt, M., Monden, K., Lopez-Ben, S., Kingham, T. P., Ferrero, A., Ettorre, G. M., Levi Sandri, G. B., Pascual, F., Cherqui, D., Liang, X., Mazzotta, A., Wakabayashi, G., Giglio, M., Troisi, R. I., Han, H. -S., Cheung, T. -T., Sugioka, A., Chen, K. -H., Liu, R., Soubrane, O., Fuks, D., Aldrighetti, L., Abu Hilal, M., Goh, B. K. P., Gastaca, M., Meurs, J., De Meyere, C., Lee, K. -F., Ng, K. K., Salimgereeva, D., Alikhanov, R., Lee, L. -S., Jang, J. Y., Kato, Y., Kojima, M., Pirola Kruger, J. A., Lopez-Lopez, V., Casellas I Robert, M., Montalti, R., Lee, B., D'Silva, M., Wang, H. -P., Saleh, M., Chen, Z., Yu, S., Vani, S., Ardito, Francesco, Giustizieri, U., Citterio, D., Mocchegiani, F., Colasanti, M., Guzman, Y., Labadie, K. P., Conticchio, M., Dogeas, E., Kauffmann, E. F., Giuffrida, M., Sommacale, D., Laurent, A., Magistri, P., Nghia, P. P., Mishima, K., Valle, B. D., Krenzien, F., Schmelzle, M., Kadam, P., Liu, Q., Lai, E. C. H., Zheng, J., Siow, T. F., Forchino, F., Giuliante F. (ORCID:0000-0001-9517-8220), Ardito F. (ORCID:0000-0003-1596-2862), Ghotbi, J., Aghayan, D., Fretland, A., Edwin, B., Syn, N. L., Cipriani, F., Alzoubi, M., Lim, C., Scatton, O., Long, T. C. D., Herman, P., Coelho, F. F., Marino, M. V., Mazzaferro, V., Chiow, A. K. H., Sucandy, I., Ivanecz, A., Choi, S. -H., Lee, J. H., Prieto, M., Vivarelli, M., Giuliante, Felice, Ruzzenente, A., Yong, C. -C., Yin, M., Fondevila, C., Efanov, M., Morise, Z., Di Benedetto, F., Brustia, R., Dalla Valle, R., Boggi, U., Geller, D., Belli, A., Memeo, R., Mejia, A., Park, J. O., Rotellar, F., Choi, G. -H., Robles-Campos, R., Wang, X., Sutcliffe, R. P., Pratschke, J., Tang, C. -N., Chong, C. C. N., D'Hondt, M., Monden, K., Lopez-Ben, S., Kingham, T. P., Ferrero, A., Ettorre, G. M., Levi Sandri, G. B., Pascual, F., Cherqui, D., Liang, X., Mazzotta, A., Wakabayashi, G., Giglio, M., Troisi, R. I., Han, H. -S., Cheung, T. -T., Sugioka, A., Chen, K. -H., Liu, R., Soubrane, O., Fuks, D., Aldrighetti, L., Abu Hilal, M., Goh, B. K. P., Gastaca, M., Meurs, J., De Meyere, C., Lee, K. -F., Ng, K. K., Salimgereeva, D., Alikhanov, R., Lee, L. -S., Jang, J. Y., Kato, Y., Kojima, M., Pirola Kruger, J. A., Lopez-Lopez, V., Casellas I Robert, M., Montalti, R., Lee, B., D'Silva, M., Wang, H. -P., Saleh, M., Chen, Z., Yu, S., Vani, S., Ardito, Francesco, Giustizieri, U., Citterio, D., Mocchegiani, F., Colasanti, M., Guzman, Y., Labadie, K. P., Conticchio, M., Dogeas, E., Kauffmann, E. F., Giuffrida, M., Sommacale, D., Laurent, A., Magistri, P., Nghia, P. P., Mishima, K., Valle, B. D., Krenzien, F., Schmelzle, M., Kadam, P., Liu, Q., Lai, E. C. H., Zheng, J., Siow, T. F., Forchino, F., Giuliante F. (ORCID:0000-0001-9517-8220), and Ardito F. (ORCID:0000-0003-1596-2862)
Abstract: Background: Minimal invasive liver resections are a safe alternative to open surgery. Different scoring systems considering different risks factors have been developed to predict the risks associated with these procedures, especially challenging major liver resections (MLR). However, the impact of neoadjuvant chemotherapy (NAT) on the difficulty of minimally invasive MLRs remains poorly investigated. Methods: Patients who underwent laparoscopic and robotic MLRs for colorectal liver metastases (CRLM) performed across 57 centers between January 2005 to December 2021 were included in this analysis. Patients who did or did not receive NAT were matched based on 1:1 coarsened exact and 1:2 propensity-score matching. Pre- and post-matching comparisons were performed. Results: In total, the data of 5189 patients were reviewed. Of these, 1411 procedures were performed for CRLM, and 1061 cases met the inclusion criteria. After excluding 27 cases with missing data on NAT, 1034 patients (NAT: n = 641; non-NAT: n = 393) were included. Before matching, baseline characteristics were vastly different. Before matching, the morbidity rate was significantly higher in the NAT-group (33.2% vs. 27.2%, p-value = 0.043). No significant differences were seen in perioperative outcomes after the coarsened exact matching. After the propensity-score matching, statistically significant higher blood loss (mean, 300 (SD 128–596) vs. 250 (SD 100–400) ml, p-value = 0.047) but shorter hospital stay (mean, 6 [4-8] vs. 6 [5-9] days, p-value = 0.043) were found in the NAT-group. Conclusion: The current study demonstrated that NAT had minimal impact on the difficulty and outcomes of minimally-invasive MLR for CRLM.
Published: 2023

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

Author: Goh, B. K. P., Han, H. -S., Chen, K. -H., Chua, D. W., Chan, C. -Y., Cipriani, F., Aghayan, D. L., Fretland, A. A., Sijberden, J., D'Silva, M., Siow, T. F., Kato, Y., Lim, C., Nghia, P. P., Herman, P., Marino, M. V., Mazzaferro, V., Chiow, A. K. H., Sucandy, I., Ivanecz, A., Choi, S. H., Lee, J. H., Gastaca, M., Vivarelli, M., Giuliante, Felice, Ruzzenente, A., Yong, C. -C., Yin, M., Chen, Z., Fondevila, C., Efanov, M., Rotellar, F., Choi, G. -H., Campos, R. R., Wang, X., Sutcliffe, R. P., Pratschke, J., Lai, E., Chong, C. C., D'Hondt, M., Monden, K., Lopez-Ben, S., Coelho, F. F., Kingham, T. P., Liu, R., Long, T. C. D., Ferrero, A., Sandri, G. B. L., Saleh, M., Cherqui, D., Scatton, O., Soubrane, O., Wakabayashi, G., Troisi, R. I., Cheung, T. -T., Sugioka, A., Hilal, M. A., Fuks, D., Edwin, B., Aldrighetti, L., Syn, N., Prieto, M., Schotte, H., De Meyere, C., Krenzien, F., Schmelzle, M., Lee, K. -F., Salimgereeva, D., Alikhanov, R., Lee, L. -S., Jang, J. Y., Kojima, M., Ghotbi, J., Kruger, J. A. P., Lopez-Lopez, V., Valle, B. D., Casellas I Robert, M., Mishima, K., Montalti, R., Giglio, M., Mazzotta, A., Lee, B., Wang, H. -P., Pascual, F., Kadam, P., Tang, C. -N., Yu, S., Ardito, Francesco, Vani, S., Giustizieri, U., Citterio, D., Mocchegiani, F., Ettorre, G. M., Colasanti, M., Guzman, Y., Giuliante F. (ORCID:0000-0001-9517-8220), Ardito F. (ORCID:0000-0003-1596-2862), Goh, B. K. P., Han, H. -S., Chen, K. -H., Chua, D. W., Chan, C. -Y., Cipriani, F., Aghayan, D. L., Fretland, A. A., Sijberden, J., D'Silva, M., Siow, T. F., Kato, Y., Lim, C., Nghia, P. P., Herman, P., Marino, M. V., Mazzaferro, V., Chiow, A. K. H., Sucandy, I., Ivanecz, A., Choi, S. H., Lee, J. H., Gastaca, M., Vivarelli, M., Giuliante, Felice, Ruzzenente, A., Yong, C. -C., Yin, M., Chen, Z., Fondevila, C., Efanov, M., Rotellar, F., Choi, G. -H., Campos, R. R., Wang, X., Sutcliffe, R. P., Pratschke, J., Lai, E., Chong, C. C., D'Hondt, M., Monden, K., Lopez-Ben, S., Coelho, F. F., Kingham, T. P., Liu, R., Long, T. C. D., Ferrero, A., Sandri, G. B. L., Saleh, M., Cherqui, D., Scatton, O., Soubrane, O., Wakabayashi, G., Troisi, R. I., Cheung, T. -T., Sugioka, A., Hilal, M. A., Fuks, D., Edwin, B., Aldrighetti, L., Syn, N., Prieto, M., Schotte, H., De Meyere, C., Krenzien, F., Schmelzle, M., Lee, K. -F., Salimgereeva, D., Alikhanov, R., Lee, L. -S., Jang, J. Y., Kojima, M., Ghotbi, J., Kruger, J. A. P., Lopez-Lopez, V., Valle, B. D., Casellas I Robert, M., Mishima, K., Montalti, R., Giglio, M., Mazzotta, A., Lee, B., Wang, H. -P., Pascual, F., Kadam, P., Tang, C. -N., Yu, S., Ardito, Francesco, Vani, S., Giustizieri, U., Citterio, D., Mocchegiani, F., Ettorre, G. M., Colasanti, M., Guzman, Y., Giuliante F. (ORCID:0000-0001-9517-8220), and Ardito F. (ORCID:0000-0003-1596-2862)
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.
Published: 2023

11. Comparison between the difficulty of laparoscopic limited liver resections of tumors located in segment 7 versus segment 8: An international multicenter propensity-score matched study

Author: Efanov, M., Salimgereeva, D., Alikhanov, R., Wu, A. G. R., Geller, D., Cipriani, F., Aghayan, D. L., Fretland, A. A., Sijberden, J., Belli, A., Marino, M. V., Mazzaferro, V., Chiow, A. K. H., Sucandy, I., Ivanecz, A., Choi, S. H., Lee, J. H., Prieto, M., Vivarelli, M., Giuliante, Felice, Ruzzenente, A., Yong, C. -C., Fondevila, C., Rotellar, F., Choi, G. -H., Robless Campos, R., Wang, X., Sutcliffe, R. P., Pratschke, J., Lai, E., Chong, C. C., D'Hondt, M., Monden, K., Lopez-Ben, S., Herman, P., Di Benedetto, F., Kingham, T. P., Liu, R., Long, T. C. D., Ferrero, A., Levi Sandri, G. B., Cherqui, D., Scatton, O., Wakabayashi, G., Troisi, R. I., Cheung, T. -T., Sugioka, A., Han, H. -S., Abu Hilal, M., Soubrane, O., Fuks, D., Aldrighetti, L., Edwin, B., Goh, B. K. P., Chan, C. -Y., Syn, N., D'Silva, M., Lee, B., Lim, C., Nghia, P. P., Gastaca, M., Schotte, H., De Meyere, C., Krenzien, F., Schmelzle, M., Lee, K. -F., Lee, L. S., Jang, J. Y., Kojima, M., Kato, Y., Ghotbi, J., Kruger, J. A. P., Coelho, F. F., Lopez-Lopez, V., Valle, B. D., Robert, M. C. I., Mishima, K., Montalti, R., Giglio, M., Wang, H. -P., Pascual, F., Saleh, M., Kadam, P., Tang, C. -N., Ardito, Francesco, Vani, S., Giustizieri, U., Citterio, D., Mocchegiani, F., Ettorre, G. M., Colasanti, M., Guzman, Y., Dogeas, E., Magistri, P., Mazzotta, A., Giuliante F. (ORCID:0000-0001-9517-8220), Ardito F. (ORCID:0000-0003-1596-2862), Efanov, M., Salimgereeva, D., Alikhanov, R., Wu, A. G. R., Geller, D., Cipriani, F., Aghayan, D. L., Fretland, A. A., Sijberden, J., Belli, A., Marino, M. V., Mazzaferro, V., Chiow, A. K. H., Sucandy, I., Ivanecz, A., Choi, S. H., Lee, J. H., Prieto, M., Vivarelli, M., Giuliante, Felice, Ruzzenente, A., Yong, C. -C., Fondevila, C., Rotellar, F., Choi, G. -H., Robless Campos, R., Wang, X., Sutcliffe, R. P., Pratschke, J., Lai, E., Chong, C. C., D'Hondt, M., Monden, K., Lopez-Ben, S., Herman, P., Di Benedetto, F., Kingham, T. P., Liu, R., Long, T. C. D., Ferrero, A., Levi Sandri, G. B., Cherqui, D., Scatton, O., Wakabayashi, G., Troisi, R. I., Cheung, T. -T., Sugioka, A., Han, H. -S., Abu Hilal, M., Soubrane, O., Fuks, D., Aldrighetti, L., Edwin, B., Goh, B. K. P., Chan, C. -Y., Syn, N., D'Silva, M., Lee, B., Lim, C., Nghia, P. P., Gastaca, M., Schotte, H., De Meyere, C., Krenzien, F., Schmelzle, M., Lee, K. -F., Lee, L. S., Jang, J. Y., Kojima, M., Kato, Y., Ghotbi, J., Kruger, J. A. P., Coelho, F. F., Lopez-Lopez, V., Valle, B. D., Robert, M. C. I., Mishima, K., Montalti, R., Giglio, M., Wang, H. -P., Pascual, F., Saleh, M., Kadam, P., Tang, C. -N., Ardito, Francesco, Vani, S., Giustizieri, U., Citterio, D., Mocchegiani, F., Ettorre, G. M., Colasanti, M., Guzman, Y., Dogeas, E., Magistri, P., Mazzotta, A., Giuliante F. (ORCID:0000-0001-9517-8220), and Ardito F. (ORCID:0000-0003-1596-2862)
Abstract: Background: Presently, according to different difficulty scoring systems, there is no difference in complexity estimation of laparoscopic liver resection (LLR) of segments 7 and 8. However, there is no published data supporting this assumption. To date, no studies have compared the outcomes of laparoscopic parenchyma-sparing resection of the liver segments 7 and 8. Methods: A post hoc analysis of patients undergoing LLR of segments 7 and 8 in 46 centers between 2004 and 2020 was performed. 1:1 Propensity score matching (PSM) was used to compare isolated LLR of segments 7 and 8. Subset analyses were also performed to compare atypical resections and segmentectomies of 7 and 8. Results: A total of 2411 patients were identified, and 1691 patients met the inclusion criteria. Comparison after PSM between the entire cohort of segment 7 and segment 8 resections revealed inferior results for segment 7 resection in terms of increased blood loss, blood transfusions, and conversions to open surgery. Subset analyses of only atypical resections similarly demonstrated poorer outcomes for segment 7 in terms of increased blood loss, operation time, blood transfusions, and conversions to open surgery. Conversely, a subgroup analysis of segmentectomies after PSM found better outcomes for segment 7 in terms of a shorter operation time and hospital stay. Conclusion: Differences in the outcomes of segments 7 and 8 resections suggest a greater difficulty of laparoscopic atypical resection of segment 7 compared to segment 8, and greater difficulty of segmentectomy 8 compared to segmentectomy 7.
Published: 2023

12. An international multicenter propensity-score matched and coarsened-exact matched analysis comparing robotic versus laparoscopic partial liver resections of the anterolateral segments

Author: Kadam P., Sutcliffe R. P., Scatton O., Sucandy I., Kingham T. P., Liu R., Choi G. H., Syn N. L., Gastaca M., Choi S. -H., Chiow A. K. H., Marino M. V., Efanov M., Lee J. -H., Chong C. C., Tang C. -N., Cheung T. -T., Pratschke J., Wang X., Campos R. R., Ivanecz A., Park J. O., Rotellar F., Fuks D., D'Hondt M., Han H. -S., Troisi R. I., Goh B. K. P., Chan C. -Y., Prieto M., Schotte H., De Meyere C., Lai E., Krenzien F., Schmelzle M., Montalti R., Liu Q., Lee K. -F., Salimgereeva D., Alikhanov R., Lee L. -S., Jang J. Y., Lim C., Labadie K. P., Lopez-Lopez V., Kadam, P., Sutcliffe, R. P., Scatton, O., Sucandy, I., Kingham, T. P., Liu, R., Choi, G. H., Syn, N. L., Gastaca, M., Choi, S. -H., Chiow, A. K. H., Marino, M. V., Efanov, M., Lee, J. -H., Chong, C. C., Tang, C. -N., Cheung, T. -T., Pratschke, J., Wang, X., Campos, R. R., Ivanecz, A., Park, J. O., Rotellar, F., Fuks, D., D'Hondt, M., Han, H. -S., Troisi, R. I., Goh, B. K. P., Chan, C. -Y., Prieto, M., Schotte, H., De Meyere, C., Lai, E., Krenzien, F., Schmelzle, M., Montalti, R., Liu, Q., Lee, K. -F., Salimgereeva, D., Alikhanov, R., Lee, L. -S., Jang, J. Y., Lim, C., Labadie, K. P., and Lopez-Lopez, V.
Subjects: Carcinoma, Hepatocellular, robotic liver resection, Hepatology, Liver Neoplasms, anterolateral segment, laparoscopic liver resection, Length of Stay, Postoperative Complications, Robotic Surgical Procedures, Hepatectomy, Humans, Laparoscopy, Surgery, Propensity Score, Retrospective Studies, minimally invasive liver surgery
Abstract: Background: Robotic liver resections (RLR) may have the ability to address some of the drawbacks of laparoscopic liver resections (LLR) but few studies have done a head-to-head comparison of the outcomes after anterolateral segment resections by the two techniques. Methods: A retrospective study was conducted of 3202 patients who underwent minimally invasive LR of the anterolateral liver segments at 26 international centres from 2005 to 2020. Two thousand six hundred and six cases met study criteria of which there were 358 RLR and 1868 LLR cases. Perioperative outcomes were compared between the two groups using a 1:3 Propensity Score Matched (PSM) and 1:1 Coarsened Exact Matched (CEM) analysis. Results: Patients matched after 1:3 PSM (261 RLR vs 783 LLR) and 1:1 CEM (296 RLR vs 296 LLR) revealed no significant differences in length of stay, readmission rates, morbidity, mortality, and involvement of or close oncological margins. RLR surgeries were associated with significantly less blood loss (50 mL vs 100 ml, P
Published: 2022

13. Utility of the Iwate difficulty scoring system for laparoscopic right posterior sectionectomy: do surgical outcomes differ for tumors in segments VI and VII?

Author: Choi S. H., Chen K. -H., Syn N. L., Cipriani F., Cheung T. -T., Chiow A. K. H., Choi G. -H., Siow T. -F., Sucandy I., Marino M. V., Gastaca M., Chong C. C., Lee J. H., Ivanecz A., Mazzaferro V., Lopez-Ben S., Fondevila C., Rotellar F., Campos R. R., Efanov M., Kingham T. P., Sutcliffe R. P., Troisi R. I., Pratschke J., Wang X., D'Hondt M., Yong C. C., Levi Sandri G. B., Tang C. N., Ruzzenente A., Cherqui D., Ferrero A., Wakabayashi G., Scatton O., Aghayan D., Edwin B., Coelho F. F., Giuliante F., Liu R., Sijberden J., Abu Hilal M., Sugioka A., Long T. C. D., Fuks D., Aldrighetti L., Han H. -S., Goh B. K. P., Kang I., Jang J. Y., Chan C. -Y., D'Silva M., Schotte H., De Meyere C., Lai E., Krenzien F., Schmelzle M., Kadam P., Montalti R., Giglio M., Liu Q., Lee K. -F., Salimgereeva D., Alikhanov R., Lee L. -S., Prieto M., Lim C., Nghia P. P., Kojima M., Kato Y., Forchino F., Herman P., Kruger J. A. P., Saleh M., Pascual F., Dalla Valle B., Lopez-Lopez V., Casellas-Robert M., Giustizieri U., Citterio D., Mishima K., Fretland A. A., Ghotbi J., Ettorre G. M., Colasanti M., Guzman Y., Ardito F., Vani S., Wang H. -P., Choi, S. H., Chen, K. -H., Syn, N. L., Cipriani, F., Cheung, T. -T., Chiow, A. K. H., Choi, G. -H., Siow, T. -F., Sucandy, I., Marino, M. V., Gastaca, M., Chong, C. C., Lee, J. H., Ivanecz, A., Mazzaferro, V., Lopez-Ben, S., Fondevila, C., Rotellar, F., Campos, R. R., Efanov, M., Kingham, T. P., Sutcliffe, R. P., Troisi, R. I., Pratschke, J., Wang, X., D'Hondt, M., Yong, C. C., Levi Sandri, G. B., Tang, C. N., Ruzzenente, A., Cherqui, D., Ferrero, A., Wakabayashi, G., Scatton, O., Aghayan, D., Edwin, B., Coelho, F. F., Giuliante, F., Liu, R., Sijberden, J., Abu Hilal, M., Sugioka, A., Long, T. C. D., Fuks, D., Aldrighetti, L., Han, H. -S., Goh, B. K. P., Kang, I., Jang, J. Y., Chan, C. -Y., D'Silva, M., Schotte, H., De Meyere, C., Lai, E., Krenzien, F., Schmelzle, M., Kadam, P., Montalti, R., Giglio, M., Liu, Q., Lee, K. -F., Salimgereeva, D., Alikhanov, R., Lee, L. -S., Prieto, M., Lim, C., Nghia, P. P., Kojima, M., Kato, Y., Forchino, F., Herman, P., Kruger, J. A. P., Saleh, M., Pascual, F., Dalla Valle, B., Lopez-Lopez, V., Casellas-Robert, M., Giustizieri, U., Citterio, D., Mishima, K., Fretland, A. A., Ghotbi, J., Ettorre, G. M., Colasanti, M., Guzman, Y., Ardito, F., Vani, S., Wang, H. -P., Choi, Sung Hoon, Chen, Kuo-Hsin, Syn, Nicholas L, Cipriani, Federica, Cheung, Tan-To, Chiow, Adrian K H, Choi, Gi-Hong, Siow, Tiing-Foong, Sucandy, Iswanto, Marino, Marco V, Gastaca, Mikel, Chong, Charing C, Lee, Jae Hoon, Ivanecz, Arpad, Mazzaferro, Vincenzo, Lopez-Ben, Santiago, Fondevila, Constantino, Rotellar, Fernando, Campos, Ricardo Roble, Efanov, Mikhail, Kingham, T Peter, Sutcliffe, Robert P, Troisi, Roberto I, Pratschke, Johann, Wang, Xiaoying, D'Hondt, Mathieu, Yong, Chee Chien, Levi Sandri, Giovanni Battista, Tang, Chung Ngai, Ruzzenente, Andrea, Cherqui, Daniel, Ferrero, Alessandro, Wakabayashi, Go, Scatton, Olivier, Aghayan, Davit, Edwin, Bjørn, Coelho, Fabricio Ferreira, Giuliante, Felice, Liu, Rong, Sijberden, Jasper, Abu Hilal, Mohammad, Sugioka, Atsushi, Long, Tran Cong Duy, Fuks, David, Aldrighetti, Luca, Han, Ho-Seong, and Goh, Brian K P
Subjects: Carcinoma, Hepatocellular, Laparoscopic liver, Settore MED/18 - CHIRURGIA GENERALE, Operative Time, Liver Neoplasms, Carcinoma, Hepatocellular, Difficulty score, Length of Stay, Iwate, Laparoscopic hepatectomy, Right posterior sectionectomy, Treatment Outcome, Postoperative Complications, Humans, Hepatectomy, Surgery, Laparoscopy, Retrospective Studies
Abstract: Introduction: The Iwate Score (IS) have not been well-validated for specific procedures, especially for right posterior sectionectomy (RPS). In this study, the utility of the IS was determined for laparoscopic (L)RPS and the effect of tumor location on surgical outcomes was investigated. Methods: Post-hoc analysis of 647 L-RPS performed in 40 international centers of which 596L-RPS cases met the inclusion criteria. Baseline characteristics and perioperative outcomes of patients stratified based on the Iwate score were compared to determine whether a correlation with surgical difficulty existed. A 1:1 Mahalanobis distance matching was utilized to investigate the effect of tumor location on L-RPS outcomes. Results: The patients were stratified into 3 levels of difficulty (31 intermediate, 143 advanced, and 422 expert) based on the IS. When using a stepwise increase of the IS excluding the tumor location score, only Pringle’s maneuver was more frequently used in the higher surgical difficulty level (35.5%, 54.6%, and 65.2%, intermediate, advanced, and expert levels, respectively, Z = 3.34, p = 0.001). Other perioperative results were not associated with a statistical gradation toward higher difficulty level. 80 of 85 patients with a segment VI lesion and 511 patients with a segment VII lesion were matched 1:1. There were no significant differences in the perioperative outcomes of the two groups including open conversion, operating time, blood loss, intraoperative blood transfusion, postoperative stay, major morbidity, and mortality. Conclusion: Among patients undergoing L-RPS, the IS did not significantly correlate with most outcome measures associated with intraoperative difficulty and postoperative outcomes. Similarly, tumor location had no effect on L-RPS outcomes.
Published: 2022

14. Comparison between the difficulty of laparoscopic limited liver resections of tumors located in segment 7 versus segment 8

Author: Efanov, M., Salimgereeva, D., Alikhanov, R., A. G. R., Wu, Geller, D., Cipriani, F., Aghayan, D. L., Fretland, A. A., Sijberden, J., Belli, A., Marino, M. V., Mazzaferro, V., Chiow, A. K. H., Sucandy, I., Ivanecz, A., Choi, S. H., Lee, J. H., Prieto, M., Vivarelli, M., Giuliante, Felice, Ruzzenente, A., Yong, C. -C., Fondevila, C., Rotellar, F., Choi, G. -H., Robless Campos, R., Wang, X., Sutcliffe, R. P., Pratschke, J., Lai, E., Chong, C. C., D'Hondt, M., Monden, K., Lopez-Ben, S., Herman, P., Di Benedetto, F., Kingham, T. P., Liu, R., Long, T. C. D., Ferrero, A., Levi Sandri, G. B., Cherqui, D., Scatton, O., Wakabayashi, G., Troisi, R. I., Cheung, T. -T., Sugioka, A., Han, H. -S., Abu Hilal, M., Soubrane, O., Fuks, D., Aldrighetti, L., Edwin, B., Goh, B. K. P., Chan, C. -Y., Syn, N., D'Silva, M., Lee, B., Lim, C., Nghia, P. P., Gastaca, M., Schotte, H., De Meyere, C., Krenzien, F., Schmelzle, M., Lee, K. -F., Lee, L. S., Jang, J. Y., Kojima, M., Kato, Y., Ghotbi, J., Kruger, J. A. P., Coelho, F. F., Lopez-Lopez, V., Valle, B. D., Robert, M. C. I., Mishima, K., Montalti, R., Giglio, M., Wang, H. -P., Pascual, F., Saleh, M., Kadam, P., Tang, C. -N., Ardito, Francesco, Vani, S., Giustizieri, U., Citterio, D., Mocchegiani, F., Ettorre, G. M., Colasanti, M., Guzman, Y., Dogeas, E., Magistri, P., Mazzotta, A., Graduate School, Surgery, CCA - Cancer Treatment and Quality of Life, Efanov, M., Salimgereeva, D., Alikhanov, R., Wu, A. G. R., Geller, D., Cipriani, F., Aghayan, D. L., Fretland, A. A., Sijberden, J., Belli, A., Marino, M. V., Mazzaferro, V., Chiow, A. K. H., Sucandy, I., Ivanecz, A., Choi, S. H., Lee, J. H., Prieto, M., Vivarelli, M., Giuliante, F., Ruzzenente, A., Yong, C. -C., Fondevila, C., Rotellar, F., Choi, G. -H., Robless Campos, R., Wang, X., Sutcliffe, R. P., Pratschke, J., Lai, E., Chong, C. C., D'Hondt, M., Monden, K., Lopez-Ben, S., Herman, P., Di Benedetto, F., Kingham, T. P., Liu, R., Long, T. C. D., Ferrero, A., Levi Sandri, G. B., Cherqui, D., Scatton, O., Wakabayashi, G., Troisi, R. I., Cheung, T. -T., Sugioka, A., Han, H. -S., Abu Hilal, M., Soubrane, O., Fuks, D., Aldrighetti, L., Edwin, B., Goh, B. K. P., Chan, C. -Y., Syn, N., D'Silva, M., Lee, B., Lim, C., Nghia, P. P., Gastaca, M., Schotte, H., De Meyere, C., Krenzien, F., Schmelzle, M., Lee, K. -F., Lee, L. S., Jang, J. Y., Kojima, M., Kato, Y., Ghotbi, J., Kruger, J. A. P., Coelho, F. F., Lopez-Lopez, V., Valle, B. D., Robert, M. C. I., Mishima, K., Montalti, R., Giglio, M., Wang, H. -P., Pascual, F., Saleh, M., Kadam, P., Tang, C. -N., Ardito, F., Vani, S., Giustizieri, U., Citterio, D., Mocchegiani, F., Ettorre, G. M., Colasanti, M., Guzman, Y., Dogeas, E., Magistri, P., Mazzotta, A., Efanov, Mikhail, Salimgereeva, Diana, Alikhanov, Ruslan, Wu, Andrew G R, Geller, David, Cipriani, Federica, Aghayan, Davit L, Fretland, Asmund Avdem, Sijberden, Jasper, Belli, Andrea, Marino, Marco V, Mazzaferro, Vincenzo, Chiow, Adrian K H, Sucandy, Iswanto, Ivanecz, Arpad, Choi, Sung Hoon, Lee, Jae Hoon, Prieto, Mikel, Vivarelli, Marco, Giuliante, Felice, Ruzzenente, Andrea, Yong, Chee-Chien, Fondevila, Constantino, Rotellar, Fernando, Choi, Gi-Hong, Robless Campos, Ricardo, Wang, Xiaoying, Sutcliffe, Robert P, Pratschke, Johann, Lai, Eric, Chong, Charing C, D'Hondt, Mathieu, Monden, Kazuteru, Lopez-Ben, Santiago, Herman, Paulo, Di Benedetto, Fabrizio, Kingham, T Peter, Liu, Rong, Long, Tran Cong Duy, Ferrero, Alessandro, Levi Sandri, Giovanni Battista, Cherqui, Daniel, Scatton, Olivier, Wakabayashi, Go, Troisi, Roberto I, Cheung, Tan-To, Sugioka, Atsushi, Han, Ho-Seong, Abu Hilal, Mohammad, Soubrane, Olivier, Fuks, David, Aldrighetti, Luca, Edwin, Bjorn, and Goh, Brian K P
Subjects: hepatectomy, laparoscopy, liver resection, posterosuperior segments, risk score, Hepatology, Settore MED/18 - CHIRURGIA GENERALE, Surgery, posterosuperior segment
Abstract: Background: Presently, according to different difficulty scoring systems, there is no difference in complexity estimation of laparoscopic liver resection (LLR) of segments 7 and 8. However, there is no published data supporting this assumption. To date, no studies have compared the outcomes of laparoscopic parenchyma-sparing resection of the liver segments 7 and 8. Methods: A post hoc analysis of patients undergoing LLR of segments 7 and 8 in 46 centers between 2004 and 2020 was performed. 1:1 Propensity score matching (PSM) was used to compare isolated LLR of segments 7 and 8. Subset analyses were also performed to compare atypical resections and segmentectomies of 7 and 8. Results: A total of 2411 patients were identified, and 1691 patients met the inclusion criteria. Comparison after PSM between the entire cohort of segment 7 and segment 8 resections revealed inferior results for segment 7 resection in terms of increased blood loss, blood transfusions, and conversions to open surgery. Subset analyses of only atypical resections similarly demonstrated poorer outcomes for segment 7 in terms of increased blood loss, operation time, blood transfusions, and conversions to open surgery. Conversely, a subgroup analysis of segmentectomies after PSM found better outcomes for segment 7 in terms of a shorter operation time and hospital stay. Conclusion: Differences in the outcomes of segments 7 and 8 resections suggest a greater difficulty of laparoscopic atypical resection of segment 7 compared to segment 8, and greater difficulty of segmentectomy 8 compared to segmentectomy 7.
Published: 2022

15. An international multicentre propensity score matched analysis comparing between robotic versus laparoscopic left lateral sectionectomy

Author: Chong Y., Prieto M., Gastaca M., Choi S. -H., Sucandy I., Chiow A. K. H., Marino M. V., Wang X., Efanov M., Schotte H., D'Hondt M., Choi G. -H., Krenzien F., Schmelzle M., Pratschke J., Kingham T. P., Giglio M., Troisi R., Lee J. H., Lai E. C., Tang C. N., Fuks D., D'Silva M., Han H. -S., Kadam P., Sutcliffe R. P., Lee K. -F., Chong C. C., Cheung T. -T., Liu Q., Liu R., Goh B. K. P., Chan C. -Y., De Meyere C., Salimgereeva D., Alikhanov R., Lee L. -S., Jang J. Y., Montalti R., Chong, Y., Prieto, M., Gastaca, M., Choi, S. -H., Sucandy, I., Chiow, A. K. H., Marino, M. V., Wang, X., Efanov, M., Schotte, H., D'Hondt, M., Choi, G. -H., Krenzien, F., Schmelzle, M., Pratschke, J., Kingham, T. P., Giglio, M., Troisi, R., Lee, J. H., Lai, E. C., Tang, C. N., Fuks, D., D'Silva, M., Han, H. -S., Kadam, P., Sutcliffe, R. P., Lee, K. -F., Chong, C. C., Cheung, T. -T., Liu, Q., Liu, R., Goh, B. K. P., Chan, C. -Y., De Meyere, C., Salimgereeva, D., Alikhanov, R., Lee, L. -S., Jang, J. Y., and Montalti, R.
Subjects: Laparoscopic, Left lateral sectionectomy, Minimally invasive surgery, Robotic
Abstract: Background: Left lateral sectionectomy (LLS) is one of the most commonly performed minimally invasive liver resections. While laparoscopic (L)-LLS is a well-established technique, over traditional open resection, it remains controversial if robotic (R)-LLS provides any advantages of L-LLS. Methods: A post hoc analysis of 997 patients from 21 international centres undergoing L-LLS or R-LLS from 2006 to 2020 was conducted. A total of 886 cases (214 R-LLS, 672 L-LLS) met study criteria. 1:1 and 1:2 propensity score matched (PSM) comparison was performed between R-LLS & L-LLS. Further subset analysis by Iwate difficulty was also performed. Outcomes measured include operating time, blood loss, open conversion, readmission rates, morbidity and mortality. Results: Comparison between R-LLS and L-LLS after PSM 1:2 demonstrated statistically significantly lower open conversion rate in R-LLS than L-LLS (0.6% versus 5%, p = 0.009) and median blood loss was also statistically significantly lower in R-LLS at 50 (80) versus 100 (170) in L-LLS (p = 0.011) after PSM 1:1 although there was no difference in the blood transfusion rate. Pringle manoeuvre was also found to be used more frequently in R-LLS, with 53(24.8%) cases versus to 84(12.5%) L-LLS cases (p < 0.001). There was no significant difference in the other key perioperative outcomes such as operating time, length of stay, postoperative morbidity, major morbidity and 90-day mortality between both groups. Conclusion: R-LLS was associated with similar key perioperative outcomes compared to L-LLS. It was also associated with significantly lower blood loss and open conversion rates compared to L-LLS.
Published: 2022

16. Impact of tumor size on the difficulty of laparoscopic left lateral sectionectomies

Author: Arizza, G., Russolillo, N., Ferrero, A., Syn, N. L., Cipriani, F., Aghayan, D., Marino, M. V., Memeo, R., Mazzaferro, V., Chiow, A. K. H., Sucandy, I., Ivanecz, A., Vivarelli, M., Di Benedetto, F., Choi, S. -H., Lee, J. H., Park, J. O., Gastaca, M., Fondevila, C., Efanov, M., Rotellar, F., Choi, G. -H., Robles-Campos, R., Wang, X., Sutcliffe, R. P., Pratschke, J., Tang, C. N., Chong, C. C., D'Hondt, M., Yong, C. C., Ruzzenente, A., Herman, P., Kingham, T. P., Scatton, O., Liu, R., Levi Sandri, G. B., Soubrane, O., Mejia, A., Lopez-Ben, S., Monden, K., Wakabayashi, G., Cherqui, D., Troisi, R. I., Yin, M., Giuliante, Felice, Geller, D., Sugioka, A., Edwin, B., Cheung, T. -T., Long, T. C. D., Hilal, M. A., Fuks, D., Chen, K. -H., Aldrighetti, L., Han, H. -S., Goh, B. K. P., Chan, C. -Y., Prieto, M., Meurs, J., De Meyere, C., Krenzien, F., Schmelzle, M., Lee, K. -F., K. K., Ng, Salimgereeva, D., Alikhanov, R., Lee, L. -S., Jang, J. Y., Labadie, K. P., Kato, Y., Kojima, M., Fretland, A. A., Ghotbi, J., Coelho, F. F., Kruger, J. A. P., Lopez-Lopez, V., Magistri, P., Robert, M. C. I., Mishima, K., Montalti, R., Giglio, M., Mazzotta, A., Lee, B., D'Silva, M., Wang, H. -P., Saleh, M., Pascual, F., Suhool, A., Nghia, P. P., Lim, C., Liu, Q., Kadam, P., Dalla Valle, B., Lai, E. C., Conticchio, M., Giustizieri, U., Citterio, D., Chen, Z., Yu, S., Ardito, Francesco, Vani, S., Dogeas, E., Siow, T. F., Mocchegianni, F., Ettorre, G. M., Colasanti, M., Guzman, Y., Arizza, G., Russolillo, N., Ferrero, A., Syn, N. L., Cipriani, F., Aghayan, D., Marino, M. V., Memeo, R., Mazzaferro, V., Chiow, A. K. H., Sucandy, I., Ivanecz, A., Vivarelli, M., Di Benedetto, F., Choi, S. -H., Lee, J. H., Park, J. O., Gastaca, M., Fondevila, C., Efanov, M., Rotellar, F., Choi, G. -H., Robles-Campos, R., Wang, X., Sutcliffe, R. P., Pratschke, J., Tang, C. N., Chong, C. C., D'Hondt, M., Yong, C. C., Ruzzenente, A., Herman, P., Kingham, T. P., Scatton, O., Liu, R., Levi Sandri, G. B., Soubrane, O., Mejia, A., Lopez-Ben, S., Monden, K., Wakabayashi, G., Cherqui, D., Troisi, R. I., Yin, M., Giuliante, F., Geller, D., Sugioka, A., Edwin, B., Cheung, T. -T., Long, T. C. D., Hilal, M. A., Fuks, D., Chen, K. -H., Aldrighetti, L., Han, H. -S., Goh, B. K. P., Chan, C. -Y., Prieto, M., Meurs, J., De Meyere, C., Krenzien, F., Schmelzle, M., Lee, K. -F., Ng, K. K., Salimgereeva, D., Alikhanov, R., Lee, L. -S., Jang, J. Y., Labadie, K. P., Kato, Y., Kojima, M., Fretland, A. A., Ghotbi, J., Coelho, F. F., Kruger, J. A. P., Lopez-Lopez, V., Magistri, P., Robert, M. C. I., Mishima, K., Montalti, R., Giglio, M., Mazzotta, A., Lee, B., D'Silva, M., Wang, H. -P., Saleh, M., Pascual, F., Suhool, A., Nghia, P. P., Lim, C., Liu, Q., Kadam, P., Dalla Valle, B., Lai, E. C., Conticchio, M., Giustizieri, U., Citterio, D., Chen, Z., Yu, S., Ardito, F., Vani, S., Dogeas, E., Siow, T. F., Mocchegianni, F., Ettorre, G. M., Colasanti, M., and Guzman, Y.
Subjects: difficulty, laparoscopic hepatectomy, laparoscopic liver, left lateral sectionectomy, size, Hepatology, Settore MED/18 - CHIRURGIA GENERALE, Surgery
Abstract: Background: Tumor size (TS) represents a critical parameter in the risk assessment of laparoscopic liver resections (LLR). Moreover, TS has been rarely related to the extent of liver resection. The aim of this study was to study the relationship between tumor size and difficulty of laparoscopic left lateral sectionectomy (L-LLS). Methods: The impact of TS cutoffs was investigated by stratifying tumor size at each 10 mm-interval. The optimal cutoffs were chosen taking into consideration the number of endpoints which show a statistically significant split around the cut-points of interest and the magnitude of relative risk after correction for multiple risk factors. Results: A total of 1910 L-LLS were included. Overall, open conversion and intraoperative blood transfusion were 3.1 and 3.3%, respectively. The major morbidity rate was 2.7% and 90-days mortality 0.6%. Three optimal TS cutoffs were identified: 40-, 70-, and 100-mm. All the selected cutoffs showed a significant discriminative power for the prediction of open conversion, operative time, blood transfusion and need of Pringle maneuver. Moreover, 70- and 100-mm cutoffs were both discriminative for estimated blood loss and major complications. A stepwise increase in rates of open conversion rate (Z = 3.90, P
Published: 2022

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

Author: Goh, B. K. P., Han, H. -S., Chen, K. -H., Chua, D. W., Chan, C. -Y., Cipriani, F., Aghayan, D. L., Fretland, A. A., Sijberden, J., D'Silva, M., Siow, T. F., Kato, Y., Lim, C., Nghia, P. P., Herman, P., Marino, M. V., Mazzaferro, V., Chiow, A. K. H., Sucandy, I., Ivanecz, A., Choi, S. H., Lee, J. H., Gastaca, M., Vivarelli, M., Giuliante, Felice, Ruzzenente, A., Yong, C. -C., Yin, M., Chen, Z., Fondevila, C., Efanov, M., Rotellar, F., Choi, G. -H., Campos, R. R., Wang, X., Sutcliffe, R. P., Pratschke, J., Lai, E., Chong, C. C., D'Hondt, M., Monden, K., Lopez-Ben, S., Coelho, F. F., Kingham, T. P., Liu, R., Long, T. C. D., Ferrero, A., Sandri, G. B. L., Saleh, M., Cherqui, D., Scatton, O., Soubrane, O., Wakabayashi, G., Troisi, R. I., Cheung, T. -T., Sugioka, A., Hilal, M. A., Fuks, D., Edwin, B., Aldrighetti, L., Syn, N., Prieto, M., Schotte, H., De Meyere, C., Krenzien, F., Schmelzle, M., Lee, K. -F., Salimgereeva, D., Alikhanov, R., Lee, L. -S., Jang, J. Y., Kojima, M., Ghotbi, J., Kruger, J. A. P., Lopez-Lopez, V., Valle, B. D., Casellas I Robert, M., Mishima, K., Montalti, R., Giglio, M., Mazzotta, A., Lee, B., Wang, H. -P., Pascual, F., Kadam, P., Tang, C. -N., Yu, S., Ardito, Francesco, Vani, S., Giustizieri, U., Citterio, D., Mocchegiani, F., Ettorre, G. M., Colasanti, M., Guzman, Y., Goh, Brian K P, Han, Ho-Seong, Chen, Kuo-Hsin, Chua, Darren W, Chan, Chung-Yip, Cipriani, Federica, Aghayan, Davit L, Fretland, Asmund A, Sijberden, Jasper, D'Silva, Mizelle, Siow, Tiing Foong, Kato, Yutaro, Lim, Chetana, Nghia, Phan Phuoc, Herman, Paulo, Marino, Marco V, Mazzaferro, Vincenzo, Chiow, Adrian K H, Sucandy, Iswanto, Ivanecz, Arpad, Choi, Sung Hoon, Lee, Jae Hoon, Gastaca, Mikel, Vivarelli, Marco, Giuliante, Felice, Ruzzenente, Andrea, Yong, Chee-Chien, Yin, Mengqui, Chen, Zewei, Fondevila, Constantino, Efanov, Mikhail, Rotellar, Fernando, Choi, Gi-Hong, Campos, Ricardo R, Wang, Xiaoying, Sutcliffe, Robert P, Pratschke, Johann, Lai, Eric, Chong, Charing C, D'Hondt, Mathieu, Monden, Kazuteru, Lopez-Ben, Santiago, Coelho, Fabricio F, Kingham, Thomas Peter, Liu, Rong, Long, Tran Cong Duy, Ferrero, Alessandro, Sandri, Giovanni B Levi, Saleh, Mansour, Cherqui, Daniel, Scatton, Olivier, Soubrane, Olivier, Wakabayashi, Go, Troisi, Roberto I, Cheung, Tan-To, Sugioka, Atsushi, Hilal, Mohammad Abu, Fuks, David, Edwin, Bjørn, and Aldrighetti, Luca
Subjects: benchmark, hepatectomy, quality assessment, Settore MED/18 - CHIRURGIA GENERALE, minimally invasive, Surgery, laparoscopic liver resection, global
Abstract: To establish global benchmark outcomes indicators after laparoscopic liver resections (L-LR).There is limited published data to date on the best achievable outcomes after L-LR.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.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.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.
Published: 2022

18. Dragon 1 Protocol Manuscript: Training, Accreditation, Implementation and Safety Evaluation of Portal and Hepatic Vein Embolization (PVE/HVE) to Accelerate Future Liver Remnant (FLR) Hypertrophy.

Author: UCL - SSS/IREC/IMAG - Pôle d'imagerie médicale, UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie, UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - (MGD) Service de chirurgie, UCL - (MGD) Service de radiologie - résonance magnétique, Korenblik, R, Olij, B, Aldrighetti, L A, Hilal, M Abu, Ahle, M, Arslan, B, van Baardewijk, L J, Baclija, I, Bent, C, Claude, Bertrand, Björnsson, B, de Boer, M T, de Boer, S W, Bokkers, R P H, Rinkes, I H M Borel, Breitenstein, S, Bruijnen, R C G, Bruners, P, Büchler, M W, Camacho, J C, Cappelli, A, Carling, U, Chan, B K Y, Chang, D H, Choi, J, Font, J Codina, Crawford, M, Croagh, D, Cugat, E, Davis, R, De Boo, D W, De Cobelli, F, De Wispelaere, Jean-François, van Delden, O M, Delle, M, Detry, O, Díaz-Nieto, R, Dili, Alexandra, Erdmann, J I, Fisher, O, Fondevila, C, Fretland, Å, Borobia, F Garcia, Gelabert, A, Gérard, L, Giuliante, F, Gobardhan, P D, Gómez, F, Grünberger, T, Grünhagen, D J, Guitart, J, Hagendoorn, J, Heil, J, Heise, D, Herrero, E, Hess, G F, Hoffmann, M H, Iezzi, R, Imani, F, Nguyen, J, Jovine, E, Kalff, J C, Kazemier, G, Kingham, T P, Kleeff, J, Kollmar, O, Leclercq, W K G, Ben, S Lopez, Lucidi, V, MacDonald, A, Madoff, D C, Manekeller, S, Martel, G, Mehrabi, A, Mehrzad, H, Meijerink, M R, Menon, K, Metrakos, P, Meyer, C, Moelker, A, Modi, S, Montanari, N, Navines, J, Neumann, U P, Peddu, P, Primrose, J N, Qu, X, Raptis, D, Ratti, F, Ridouani, F, Rogan, C, Ronellenfitsch, U, Ryan, S, Sallemi, C, Moragues, J Sampere, Sandström, P, Sarriá, L, Schnitzbauer, A, Serenari, M, Serrablo, A, Smits, M L J, Sparrelid, E, Spüntrup, E, Stavrou, G A, Sutcliffe, R P, Tancredi, I, Tasse, J C, Udupa, V, Valenti, D, Fundora, Y, Vogl, T J, Wang, X, White, S A, Wohlgemuth, W A, Yu, D, Zijlstra, I A J, Binkert, C A, Bemelmans, M H A, van der Leij, C, Schadde, E, van Dam, R M, UCL - SSS/IREC/IMAG - Pôle d'imagerie médicale, UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie, UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - (MGD) Service de chirurgie, UCL - (MGD) Service de radiologie - résonance magnétique, Korenblik, R, Olij, B, Aldrighetti, L A, Hilal, M Abu, Ahle, M, Arslan, B, van Baardewijk, L J, Baclija, I, Bent, C, Claude, Bertrand, Björnsson, B, de Boer, M T, de Boer, S W, Bokkers, R P H, Rinkes, I H M Borel, Breitenstein, S, Bruijnen, R C G, Bruners, P, Büchler, M W, Camacho, J C, Cappelli, A, Carling, U, Chan, B K Y, Chang, D H, Choi, J, Font, J Codina, Crawford, M, Croagh, D, Cugat, E, Davis, R, De Boo, D W, De Cobelli, F, De Wispelaere, Jean-François, van Delden, O M, Delle, M, Detry, O, Díaz-Nieto, R, Dili, Alexandra, Erdmann, J I, Fisher, O, Fondevila, C, Fretland, Å, Borobia, F Garcia, Gelabert, A, Gérard, L, Giuliante, F, Gobardhan, P D, Gómez, F, Grünberger, T, Grünhagen, D J, Guitart, J, Hagendoorn, J, Heil, J, Heise, D, Herrero, E, Hess, G F, Hoffmann, M H, Iezzi, R, Imani, F, Nguyen, J, Jovine, E, Kalff, J C, Kazemier, G, Kingham, T P, Kleeff, J, Kollmar, O, Leclercq, W K G, Ben, S Lopez, Lucidi, V, MacDonald, A, Madoff, D C, Manekeller, S, Martel, G, Mehrabi, A, Mehrzad, H, Meijerink, M R, Menon, K, Metrakos, P, Meyer, C, Moelker, A, Modi, S, Montanari, N, Navines, J, Neumann, U P, Peddu, P, Primrose, J N, Qu, X, Raptis, D, Ratti, F, Ridouani, F, Rogan, C, Ronellenfitsch, U, Ryan, S, Sallemi, C, Moragues, J Sampere, Sandström, P, Sarriá, L, Schnitzbauer, A, Serenari, M, Serrablo, A, Smits, M L J, Sparrelid, E, Spüntrup, E, Stavrou, G A, Sutcliffe, R P, Tancredi, I, Tasse, J C, Udupa, V, Valenti, D, Fundora, Y, Vogl, T J, Wang, X, White, S A, Wohlgemuth, W A, Yu, D, Zijlstra, I A J, Binkert, C A, Bemelmans, M H A, van der Leij, C, Schadde, E, and van Dam, R M
Abstract: The DRAGON 1 trial aims to assess training, implementation, safety and feasibility of combined portal- and hepatic-vein embolization (PVE/HVE) to accelerate future liver remnant (FLR) hypertrophy in patients with borderline resectable colorectal cancer liver metastases. The DRAGON 1 trial is a worldwide multicenter prospective single arm trial. The primary endpoint is a composite of the safety of PVE/HVE, 90-day mortality, and one year accrual monitoring of each participating center. Secondary endpoints include: feasibility of resection, the used PVE and HVE techniques, FLR-hypertrophy, liver function (subset of centers), overall survival, and disease-free survival. All complications after the PVE/HVE procedure are documented. Liver volumes will be measured at week 1 and if applicable at week 3 and 6 after PVE/HVE and follow-up visits will be held at 1, 3, 6, and 12 months after the resection. Not applicable. DRAGON 1 is a prospective trial to assess the safety and feasibility of PVE/HVE. Participating study centers will be trained, and procedures standardized using Work Instructions (WI) to prepare for the DRAGON 2 randomized controlled trial. Outcomes should reveal the accrual potential of centers, safety profile of combined PVE/HVE and the effect of FLR-hypertrophy induction by PVE/HVE in patients with CRLM and a small FLR. Clinicaltrials.gov: NCT04272931 (February 17, 2020). Toestingonline.nl: NL71535.068.19 (September 20, 2019).
Published: 2022

19. Impact of enhanced recovery protocols after pancreatoduodenectomy: Meta-Analysis

Author: Kuemmerli, C, Tschuor, C, Kasai, M, Alseidi, A, Balzano, G, Bouwense, S, Braga, M, Coolsen, M, Daniel, S, Dervenis, C, Falconi, M, Hwang, D, Kagedan, D, Kim, S, Lavu, H, Liang, T, Nussbaum, D, Partelli, S, Passeri, M, Pecorelli, N, Pillai, S, Pillarisetty, V, Pucci, M, Su, W, Sutcliffe, R, Tingstedt, B, Van Der Kolk, M, Vrochides, D, Wei, A, Yeo, C, Zani, S, Zouros, E, Abu Hilal, M, Kuemmerli C., Tschuor C., Kasai M., Alseidi A. A., Balzano G., Bouwense S., Braga M., Coolsen M., Daniel S. K., Dervenis C., Falconi M., Hwang D. W., Kagedan D. J., Kim S. C., Lavu H., Liang T., Nussbaum D., Partelli S., Passeri M. J., Pecorelli N., Pillai S. A., Pillarisetty V. G., Pucci M. J., Su W., Sutcliffe R. P., Tingstedt B., Van Der Kolk M., Vrochides D., Wei A., Yeo C. J., Zani S., Zouros E., Abu Hilal M., Kuemmerli, C, Tschuor, C, Kasai, M, Alseidi, A, Balzano, G, Bouwense, S, Braga, M, Coolsen, M, Daniel, S, Dervenis, C, Falconi, M, Hwang, D, Kagedan, D, Kim, S, Lavu, H, Liang, T, Nussbaum, D, Partelli, S, Passeri, M, Pecorelli, N, Pillai, S, Pillarisetty, V, Pucci, M, Su, W, Sutcliffe, R, Tingstedt, B, Van Der Kolk, M, Vrochides, D, Wei, A, Yeo, C, Zani, S, Zouros, E, Abu Hilal, M, Kuemmerli C., Tschuor C., Kasai M., Alseidi A. A., Balzano G., Bouwense S., Braga M., Coolsen M., Daniel S. K., Dervenis C., Falconi M., Hwang D. W., Kagedan D. J., Kim S. C., Lavu H., Liang T., Nussbaum D., Partelli S., Passeri M. J., Pecorelli N., Pillai S. A., Pillarisetty V. G., Pucci M. J., Su W., Sutcliffe R. P., Tingstedt B., Van Der Kolk M., Vrochides D., Wei A., Yeo C. J., Zani S., Zouros E., and Abu Hilal M.
Abstract: Background: This individual-patient data meta-Analysis investigated the effects of enhanced recovery after surgery (ERAS) protocols compared with conventional care on postoperative outcomes in patients undergoing pancreatoduodenectomy. Methods: The Cochrane Library, MEDLINE, Embase, Scopus, and Web of Science were searched systematically for articles reporting outcomes of ERAS after pancreatoduodenectomy published up to August 2020. Comparative studies were included. Main outcomes were postoperative functional recovery elements, postoperative morbidity, duration of hospital stay, and readmission. Results: Individual-patient data were obtained from 17 of 31 eligible studies comprising 3108 patients. Time to liquid (mean difference (MD)-3.23 (95 per cent c.i.-4.62 to-1.85) days; P < 0.001) and solid (-3.84 (-5.09 to-2.60) days; P < 0.001) intake, time to passage of first stool (MD-1.38 (-1.82 to-0.94) days; P < 0.001) and time to removal of the nasogastric tube (3.03 (-4.87 to-1.18) days; P = 0.001) were reduced with ERAS. ERAS was associated with lower overall morbidity (risk difference (RD)-0.04, 95 per cent c.i.-0.08 to-0.01; P = 0.015), less delayed gastric emptying (RD-0.11,-0.22 to-0.01; P = 0.039) and a shorter duration of hospital stay (MD-2.33 (-2.98 to-1.69) days; P < 0.001) without a higher readmission rate. Conclusion: ERAS improved postoperative outcome after pancreatoduodenectomy. Implementation should be encouraged.
Published: 2022

20. Utility of the Iwate difficulty scoring system for laparoscopic right posterior sectionectomy: do surgical outcomes differ for tumors in segments VI and VII?

Author: Choi, S. H., Chen, K. -H., Syn, N. L., Cipriani, F., Cheung, T. -T., Chiow, A. K. H., Choi, G. -H., Siow, T. -F., Sucandy, I., Marino, M. V., Gastaca, M., Chong, C. C., Lee, J. H., Ivanecz, A., Mazzaferro, V., Lopez-Ben, S., Fondevila, C., Rotellar, F., Campos, R. R., Efanov, M., Kingham, T. P., Sutcliffe, R. P., Troisi, R. I., Pratschke, J., Wang, X., D'Hondt, M., Yong, C. C., Levi Sandri, G. B., Tang, C. N., Ruzzenente, A., Cherqui, D., Ferrero, A., Wakabayashi, G., Scatton, O., Aghayan, D., Edwin, B., Coelho, F. F., Giuliante, Felice, Liu, R., Sijberden, J., Abu Hilal, M., Sugioka, A., Long, T. C. D., Fuks, D., Aldrighetti, L., Han, H. -S., Goh, B. K. P., Kang, I., Jang, J. Y., Chan, C. -Y., D'Silva, M., Schotte, H., De Meyere, C., Lai, E., Krenzien, F., Schmelzle, M., Kadam, P., Montalti, R., Giglio, M., Liu, Q., Lee, K. -F., Salimgereeva, D., Alikhanov, R., Lee, L. -S., Prieto, M., Lim, C., Nghia, P. P., Kojima, M., Kato, Y., Forchino, F., Herman, P., Kruger, J. A. P., Saleh, M., Pascual, F., Dalla Valle, B., Lopez-Lopez, V., Casellas-Robert, M., Giustizieri, U., Citterio, D., Mishima, K., Fretland, A. A., Ghotbi, J., Ettorre, G. M., Colasanti, M., Guzman, Y., Ardito, Francesco, Vani, S., Wang, H. -P., Giuliante F. (ORCID:0000-0001-9517-8220), Ardito F. (ORCID:0000-0003-1596-2862), Choi, S. H., Chen, K. -H., Syn, N. L., Cipriani, F., Cheung, T. -T., Chiow, A. K. H., Choi, G. -H., Siow, T. -F., Sucandy, I., Marino, M. V., Gastaca, M., Chong, C. C., Lee, J. H., Ivanecz, A., Mazzaferro, V., Lopez-Ben, S., Fondevila, C., Rotellar, F., Campos, R. R., Efanov, M., Kingham, T. P., Sutcliffe, R. P., Troisi, R. I., Pratschke, J., Wang, X., D'Hondt, M., Yong, C. C., Levi Sandri, G. B., Tang, C. N., Ruzzenente, A., Cherqui, D., Ferrero, A., Wakabayashi, G., Scatton, O., Aghayan, D., Edwin, B., Coelho, F. F., Giuliante, Felice, Liu, R., Sijberden, J., Abu Hilal, M., Sugioka, A., Long, T. C. D., Fuks, D., Aldrighetti, L., Han, H. -S., Goh, B. K. P., Kang, I., Jang, J. Y., Chan, C. -Y., D'Silva, M., Schotte, H., De Meyere, C., Lai, E., Krenzien, F., Schmelzle, M., Kadam, P., Montalti, R., Giglio, M., Liu, Q., Lee, K. -F., Salimgereeva, D., Alikhanov, R., Lee, L. -S., Prieto, M., Lim, C., Nghia, P. P., Kojima, M., Kato, Y., Forchino, F., Herman, P., Kruger, J. A. P., Saleh, M., Pascual, F., Dalla Valle, B., Lopez-Lopez, V., Casellas-Robert, M., Giustizieri, U., Citterio, D., Mishima, K., Fretland, A. A., Ghotbi, J., Ettorre, G. M., Colasanti, M., Guzman, Y., Ardito, Francesco, Vani, S., Wang, H. -P., Giuliante F. (ORCID:0000-0001-9517-8220), and Ardito F. (ORCID:0000-0003-1596-2862)
Abstract: Introduction: The Iwate Score (IS) have not been well-validated for specific procedures, especially for right posterior sectionectomy (RPS). In this study, the utility of the IS was determined for laparoscopic (L)RPS and the effect of tumor location on surgical outcomes was investigated. Methods: Post-hoc analysis of 647 L-RPS performed in 40 international centers of which 596L-RPS cases met the inclusion criteria. Baseline characteristics and perioperative outcomes of patients stratified based on the Iwate score were compared to determine whether a correlation with surgical difficulty existed. A 1:1 Mahalanobis distance matching was utilized to investigate the effect of tumor location on L-RPS outcomes. Results: The patients were stratified into 3 levels of difficulty (31 intermediate, 143 advanced, and 422 expert) based on the IS. When using a stepwise increase of the IS excluding the tumor location score, only Pringle’s maneuver was more frequently used in the higher surgical difficulty level (35.5%, 54.6%, and 65.2%, intermediate, advanced, and expert levels, respectively, Z = 3.34, p = 0.001). Other perioperative results were not associated with a statistical gradation toward higher difficulty level. 80 of 85 patients with a segment VI lesion and 511 patients with a segment VII lesion were matched 1:1. There were no significant differences in the perioperative outcomes of the two groups including open conversion, operating time, blood loss, intraoperative blood transfusion, postoperative stay, major morbidity, and mortality. Conclusion: Among patients undergoing L-RPS, the IS did not significantly correlate with most outcome measures associated with intraoperative difficulty and postoperative outcomes. Similarly, tumor location had no effect on L-RPS outcomes.
Published: 2022

21. Dragon 1 Protocol Manuscript:Training, Accreditation, Implementation and Safety Evaluation of Portal and Hepatic Vein Embolization (PVE/HVE) to Accelerate Future Liver Remnant (FLR) Hypertrophy

Author: Korenblik, R., Olij, B., Aldrighetti, L. A., Hilal, M. Abu, Ahle, M., Arslan, B., van Baardewijk, L. J., Baclija, I., Bent, C., Bertrand, C. L., Björnsson, B., de Boer, M. T., de Boer, S. W., Bokkers, R. P.H., Rinkes, I. H.M.Borel, Breitenstein, S., Bruijnen, R. C.G., Bruners, P., Büchler, M. W., Camacho, J. C., Cappelli, A., Carling, U., Chan, B. K.Y., Chang, D. H., choi, J., Font, J. Codina, Crawford, M., Croagh, D., Cugat, E., Davis, R., De Boo, D. W., De Cobelli, F., De Wispelaere, J. F., van Delden, O. M., Delle, M., Detry, O., Díaz-Nieto, R., Dili, A., Erdmann, J. I., Fisher, O., Fondevila, C., Fretland, Borobia, F. Garcia, Gelabert, A., Gérard, L., Giuliante, F., Gobardhan, P. D., Gómez, F., Grünberger, T., Grünhagen, D. J., Guitart, J., Hagendoorn, J., Heil, J., Heise, D., Herrero, E., Hess, G. F., Hoffmann, M. H., Iezzi, R., Imani, F., Nguyen, J., Jovine, E., Kalff, J. C., Kazemier, G., Kingham, T. P., Kleeff, J., Kollmar, O., Leclercq, W. K.G., Ben, S. Lopez, Lucidi, V., MacDonald, A., Madoff, D. C., Manekeller, S., Martel, G., Mehrabi, A., Mehrzad, H., Meijerink, M. R., Menon, K., Metrakos, P., Meyer, C., Moelker, A., Modi, S., Montanari, N., Navines, J., Neumann, U. P., Peddu, P., Primrose, J. N., Qu, X., Raptis, D., Ratti, F., Ridouani, F., Rogan, C., Ronellenfitsch, U., Ryan, S., Sallemi, C., Moragues, J. Sampere, Sandström, P., Sarriá, L., Schnitzbauer, A., Serenari, M., Serrablo, A., Smits, M. L.J., Sparrelid, E., Spüntrup, E., Stavrou, G. A., Sutcliffe, R. P., Tancredi, I., Tasse, J. C., Udupa, V., Valenti, D., Fundora, Y., Vogl, T. J., Wang, X., White, S. A., Wohlgemuth, W. A., Yu, D., Zijlstra, I. A.J., Binkert, C. A., Bemelmans, M. H.A., van der Leij, C., Schadde, E., van Dam, R. M., Korenblik, R., Olij, B., Aldrighetti, L. A., Hilal, M. Abu, Ahle, M., Arslan, B., van Baardewijk, L. J., Baclija, I., Bent, C., Bertrand, C. L., Björnsson, B., de Boer, M. T., de Boer, S. W., Bokkers, R. P.H., Rinkes, I. H.M.Borel, Breitenstein, S., Bruijnen, R. C.G., Bruners, P., Büchler, M. W., Camacho, J. C., Cappelli, A., Carling, U., Chan, B. K.Y., Chang, D. H., choi, J., Font, J. Codina, Crawford, M., Croagh, D., Cugat, E., Davis, R., De Boo, D. W., De Cobelli, F., De Wispelaere, J. F., van Delden, O. M., Delle, M., Detry, O., Díaz-Nieto, R., Dili, A., Erdmann, J. I., Fisher, O., Fondevila, C., Fretland, Borobia, F. Garcia, Gelabert, A., Gérard, L., Giuliante, F., Gobardhan, P. D., Gómez, F., Grünberger, T., Grünhagen, D. J., Guitart, J., Hagendoorn, J., Heil, J., Heise, D., Herrero, E., Hess, G. F., Hoffmann, M. H., Iezzi, R., Imani, F., Nguyen, J., Jovine, E., Kalff, J. C., Kazemier, G., Kingham, T. P., Kleeff, J., Kollmar, O., Leclercq, W. K.G., Ben, S. Lopez, Lucidi, V., MacDonald, A., Madoff, D. C., Manekeller, S., Martel, G., Mehrabi, A., Mehrzad, H., Meijerink, M. R., Menon, K., Metrakos, P., Meyer, C., Moelker, A., Modi, S., Montanari, N., Navines, J., Neumann, U. P., Peddu, P., Primrose, J. N., Qu, X., Raptis, D., Ratti, F., Ridouani, F., Rogan, C., Ronellenfitsch, U., Ryan, S., Sallemi, C., Moragues, J. Sampere, Sandström, P., Sarriá, L., Schnitzbauer, A., Serenari, M., Serrablo, A., Smits, M. L.J., Sparrelid, E., Spüntrup, E., Stavrou, G. A., Sutcliffe, R. P., Tancredi, I., Tasse, J. C., Udupa, V., Valenti, D., Fundora, Y., Vogl, T. J., Wang, X., White, S. A., Wohlgemuth, W. A., Yu, D., Zijlstra, I. A.J., Binkert, C. A., Bemelmans, M. H.A., van der Leij, C., Schadde, E., and van Dam, R. M.
Abstract: Study Purpose: The DRAGON 1 trial aims to assess training, implementation, safety and feasibility of combined portal- and hepatic-vein embolization (PVE/HVE) to accelerate future liver remnant (FLR) hypertrophy in patients with borderline resectable colorectal cancer liver metastases. Methods: The DRAGON 1 trial is a worldwide multicenter prospective single arm trial. The primary endpoint is a composite of the safety of PVE/HVE, 90-day mortality, and one year accrual monitoring of each participating center. Secondary endpoints include: feasibility of resection, the used PVE and HVE techniques, FLR-hypertrophy, liver function (subset of centers), overall survival, and disease-free survival. All complications after the PVE/HVE procedure are documented. Liver volumes will be measured at week 1 and if applicable at week 3 and 6 after PVE/HVE and follow-up visits will be held at 1, 3, 6, and 12 months after the resection. Results: Not applicable. Conclusion: DRAGON 1 is a prospective trial to assess the safety and feasibility of PVE/HVE. Participating study centers will be trained, and procedures standardized using Work Instructions (WI) to prepare for the DRAGON 2 randomized controlled trial. Outcomes should reveal the accrual potential of centers, safety profile of combined PVE/HVE and the effect of FLR-hypertrophy induction by PVE/HVE in patients with CRLM and a small FLR. Trial Registration: Clinicaltrials.gov: NCT04272931 (February 17, 2020). Toestingonline.nl: NL71535.068.19 (September 20, 2019).
Published: 2022

22. Dragon 1 Protocol Manuscript: Training, Accreditation, Implementation and Safety Evaluation of Portal and Hepatic Vein Embolization (PVE/HVE) to Accelerate Future Liver Remnant (FLR) Hypertrophy

Author: Zorgeenheid Orthopaedie Medisch, MS Radiologie, MS CGO, Regenerative Medicine and Stem Cells, Cancer, Other research (not in main researchprogram), Experimentele Afdeling Longziekten, Korenblik, R, Olij, B, Aldrighetti, L A, Hilal, M Abu, Ahle, M, Arslan, B, van Baardewijk, L J, Baclija, I, Bent, C, Bertrand, C L, Björnsson, B, de Boer, M T, de Boer, S W, Bokkers, R P H, Rinkes, I H M Borel, Breitenstein, S, Bruijnen, R C G, Bruners, P, Büchler, M W, Camacho, J C, Cappelli, A, Carling, U, Chan, B K Y, Chang, D H, Choi, J, Font, J Codina, Crawford, M, Croagh, D, Cugat, E, Davis, R, De Boo, D W, De Cobelli, F, De Wispelaere, J F, van Delden, O M, Delle, M, Detry, O, Díaz-Nieto, R, Dili, A, Erdmann, J I, Fisher, O, Fondevila, C, Fretland, Å, Borobia, F Garcia, Gelabert, A, Gérard, L, Giuliante, F, Gobardhan, P D, Gómez, F, Grünberger, T, Grünhagen, D J, Guitart, J, Hagendoorn, J, Heil, J, Heise, D, Herrero, E, Hess, G F, Hoffmann, M H, Iezzi, R, Imani, F, Nguyen, J, Jovine, E, Kalff, J C, Kazemier, G, Kingham, T P, Kleeff, J, Kollmar, O, Leclercq, W K G, Ben, S Lopez, Lucidi, V, MacDonald, A, Madoff, D C, Manekeller, S, Martel, G, Mehrabi, A, Mehrzad, H, Meijerink, M R, Menon, K, Metrakos, P, Meyer, C, Moelker, A, Modi, S, Montanari, N, Navines, J, Neumann, U P, Peddu, P, Primrose, J N, Qu, X, Raptis, D, Ratti, F, Ridouani, F, Rogan, C, Ronellenfitsch, U, Ryan, S, Sallemi, C, Moragues, J Sampere, Sandström, P, Sarriá, L, Schnitzbauer, A, Serenari, M, Serrablo, A, Smits, M L J, Sparrelid, E, Spüntrup, E, Stavrou, G A, Sutcliffe, R P, Tancredi, I, Tasse, J C, Udupa, V, Valenti, D, Fundora, Y, Vogl, T J, Wang, X, White, S A, Wohlgemuth, W A, Yu, D, Zijlstra, I A J, Binkert, C A, Bemelmans, M H A, van der Leij, C, Schadde, E, van Dam, R M, Zorgeenheid Orthopaedie Medisch, MS Radiologie, MS CGO, Regenerative Medicine and Stem Cells, Cancer, Other research (not in main researchprogram), Experimentele Afdeling Longziekten, Korenblik, R, Olij, B, Aldrighetti, L A, Hilal, M Abu, Ahle, M, Arslan, B, van Baardewijk, L J, Baclija, I, Bent, C, Bertrand, C L, Björnsson, B, de Boer, M T, de Boer, S W, Bokkers, R P H, Rinkes, I H M Borel, Breitenstein, S, Bruijnen, R C G, Bruners, P, Büchler, M W, Camacho, J C, Cappelli, A, Carling, U, Chan, B K Y, Chang, D H, Choi, J, Font, J Codina, Crawford, M, Croagh, D, Cugat, E, Davis, R, De Boo, D W, De Cobelli, F, De Wispelaere, J F, van Delden, O M, Delle, M, Detry, O, Díaz-Nieto, R, Dili, A, Erdmann, J I, Fisher, O, Fondevila, C, Fretland, Å, Borobia, F Garcia, Gelabert, A, Gérard, L, Giuliante, F, Gobardhan, P D, Gómez, F, Grünberger, T, Grünhagen, D J, Guitart, J, Hagendoorn, J, Heil, J, Heise, D, Herrero, E, Hess, G F, Hoffmann, M H, Iezzi, R, Imani, F, Nguyen, J, Jovine, E, Kalff, J C, Kazemier, G, Kingham, T P, Kleeff, J, Kollmar, O, Leclercq, W K G, Ben, S Lopez, Lucidi, V, MacDonald, A, Madoff, D C, Manekeller, S, Martel, G, Mehrabi, A, Mehrzad, H, Meijerink, M R, Menon, K, Metrakos, P, Meyer, C, Moelker, A, Modi, S, Montanari, N, Navines, J, Neumann, U P, Peddu, P, Primrose, J N, Qu, X, Raptis, D, Ratti, F, Ridouani, F, Rogan, C, Ronellenfitsch, U, Ryan, S, Sallemi, C, Moragues, J Sampere, Sandström, P, Sarriá, L, Schnitzbauer, A, Serenari, M, Serrablo, A, Smits, M L J, Sparrelid, E, Spüntrup, E, Stavrou, G A, Sutcliffe, R P, Tancredi, I, Tasse, J C, Udupa, V, Valenti, D, Fundora, Y, Vogl, T J, Wang, X, White, S A, Wohlgemuth, W A, Yu, D, Zijlstra, I A J, Binkert, C A, Bemelmans, M H A, van der Leij, C, Schadde, E, and van Dam, R M
Published: 2022

23. Propensity‐matched analysis of the influence of perioperative statin therapy on outcomes after liver resection

Author: Dasari, B. V. M., Pathanki, A., Hodson, J., Roberts, K. J., Marudanayagam, R., Mirza, D. F., Isaac, J., Sutcliffe, R. P., and Muiesan, P.
Subjects: Male, lcsh:Surgery, Original Articles, lcsh:RD1-811, Middle Aged, Propensity-matched analysis, perioperative statin therapy, liver resection, Perioperative Care, Postoperative Complications, Treatment Outcome, Hepatectomy, Humans, Original Article, Female, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Propensity Score, Liver Failure, Aged, Retrospective Studies
Abstract: Background Perioperative use of statins is reported to improve postoperative outcomes after cardiac and non‐cardiovascular surgery. The aim of this study was to investigate the influence of statins on postoperative outcomes including complications of grade IIIa and above, posthepatectomy liver failure (PHLF), and 90‐day mortality rates after liver resection. Methods Patients who underwent hepatectomy between 2013 and 2017 were reviewed to identify statin users and non‐users (controls). Propensity matching was conducted for age, BMI, type of surgery and preoperative co‐morbidities to compare subgroups. Univariable and multivariable analyses were performed for the following outcomes: 90‐day mortality, significant postoperative complications and PHLF. Results Of 890 patients who had liver resection during the study period, 162 (18·2 per cent) were taking perioperative statins. Propensity analysis selected two matched groups, each comprising 154 patients. Overall, 81 patients (9·1 per cent) developed complications of grade IIIa or above, and the 90‐day mortality rate was 3·4 per cent (30 patients), with no statistically significant difference when the groups were compared before and after matching. The rate of PHLF was significantly lower in patients on perioperative statins than in those not taking statins (10·5 versus 17·3 per cent respectively; P = 0·033); similar results were found after propensity matching (10·4 versus 20·8 per cent respectively; P = 0·026). Conclusion The rate of PHLF was significantly lower in patients taking perioperative statins, but there was no statistically significant difference in severe complications and mortality rates.
Published: 2019

24. OC-108 Effect of internal and external pancreatic duct stents on outcome after pancreaticoduodenectomy: meta-analysis of randomised and observational studies

Author: Viñuela, E, Bramhall, S R, Isaac, J, Marudanayagam, R, Mayer, D, Mirza, D F, Muiesan, P, and Sutcliffe, R P
Published: 2012
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25. Mocvd of Cu on Teflon-AF and Alumina-Modified Teflon-AF

Author: Martini, D., Sutcliffe, R., and Kelber, J.
Published: 1997
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26. Anastomotic strictures and delayed gastric emptying after esophagectomy: incidence, risk factors and management

Author: Sutcliffe, R. P., Forshaw, M. J., Tandon, R., Rohatgi, A., Strauss, D. C., Botha, A. J., and Mason, R. C.
Published: 2008

27. THE EFFECT OF RECONFIGURATION

Author: Sutcliffe, R P and Hale, P C
Published: 2007

28. Jejunal transection after blunt abdominal trauma: a report of two cases

Author: Sandiford, N A, Sutcliffe, R P, and Khawaja, H T
Published: 2006

29. Post cholecystectomy bile duct injury : early, intermediate or late repair with hepaticojejunostomy - an E-AHPBA multi-center study

Author: Rystedt, Jenny M. L., Kleeff, Joerg, Salvia, Roberto, Besselink, Mark G., Prasad, Raj, Lesurtel, Mickael, Sturesson, Christian, Abu Hilal, M., Aljaiuossi, A., Antonucci, A., Ardito, F., Ausania, F., Bernon, M., Berrevoet, F., Bjornsson, B., Bonsing, B. A., Boonstra, E. A., Bracke, B., Brusadin, R., Burda, L., Caraballo, M., Casellas-Robert, M., Coker, A., Davide, J., De Gelder, A., De Rose, A. M., Djokic, M., Dudek, K., Ekmekcigil, E., Filauro, M., Fulop, A., Gallagher, T. K., Gastaca, M., Gefen, R., Giuliante, F., Habibeh, H., Halle-Smith, J., Haraldsdottir, K. H., Hartman, V, Hauer, A., Hemmingsson, O., Hoskovec, D., Isaksson, Bengt, Jonas, E., A, Khalaileh, Klug, R., Krige, J., Lignier, D., Lindemann, J., Lopez-Lopez, V, Lucidi, V, Mabrut, J-Y, Månsson, Christopher, Mieog, S., Mirza, D. F., Oldhafer, K. J., Omoshoro-Jones, J. A. O., Ortega-Torrecilla, N., Otto, W., Panaro, F., Pando, E., Paterna-Lopez, S., Pekmezci, S., Pesce, A., Porte, R. J., Poves, I, Prieto Calvo, M., Primavesi, F., Puleo, S., Recordare, A., Rizell, M., Roberts, K., Robles-Campos, R., Sanchiz-Cardenas, E., Sandstrom, P., Saribeyoglu, K., Schauer, M., Schreuder, M., Siriwardena, A. K., Smith, M. D., Silva, Sousa D., Sparrelid, E., Staettner, S., Stavrou, G. A., Straka, M., Stromberg, C., Sutcliffe, R. P., Szijarto, A., Taflin, H., Trotovsek, B., van Gulik, T., Wallach, N., Zieniewicz, K., Rystedt, Jenny M. L., Kleeff, Joerg, Salvia, Roberto, Besselink, Mark G., Prasad, Raj, Lesurtel, Mickael, Sturesson, Christian, Abu Hilal, M., Aljaiuossi, A., Antonucci, A., Ardito, F., Ausania, F., Bernon, M., Berrevoet, F., Bjornsson, B., Bonsing, B. A., Boonstra, E. A., Bracke, B., Brusadin, R., Burda, L., Caraballo, M., Casellas-Robert, M., Coker, A., Davide, J., De Gelder, A., De Rose, A. M., Djokic, M., Dudek, K., Ekmekcigil, E., Filauro, M., Fulop, A., Gallagher, T. K., Gastaca, M., Gefen, R., Giuliante, F., Habibeh, H., Halle-Smith, J., Haraldsdottir, K. H., Hartman, V, Hauer, A., Hemmingsson, O., Hoskovec, D., Isaksson, Bengt, Jonas, E., A, Khalaileh, Klug, R., Krige, J., Lignier, D., Lindemann, J., Lopez-Lopez, V, Lucidi, V, Mabrut, J-Y, Månsson, Christopher, Mieog, S., Mirza, D. F., Oldhafer, K. J., Omoshoro-Jones, J. A. O., Ortega-Torrecilla, N., Otto, W., Panaro, F., Pando, E., Paterna-Lopez, S., Pekmezci, S., Pesce, A., Porte, R. J., Poves, I, Prieto Calvo, M., Primavesi, F., Puleo, S., Recordare, A., Rizell, M., Roberts, K., Robles-Campos, R., Sanchiz-Cardenas, E., Sandstrom, P., Saribeyoglu, K., Schauer, M., Schreuder, M., Siriwardena, A. K., Smith, M. D., Silva, Sousa D., Sparrelid, E., Staettner, S., Stavrou, G. A., Straka, M., Stromberg, C., Sutcliffe, R. P., Szijarto, A., Taflin, H., Trotovsek, B., van Gulik, T., Wallach, N., and Zieniewicz, K.
Abstract: Background: Treatment of bile duct injuries (BDI) during cholecystectomy depends on the severity of injury and the timing of diagnosis. Standard of care for severe BDIs is hepaticojejunostomy. The aim of this retrospective multi-center study was to assess the optimal timing for repair of BDI with hepaticojejunostomy. Methods: Members of the European-African HepatoPancreatoBiliary Association were invited to report all consecutive patients with hepaticojejunostomy after BDI from January 2000 to June 2016. Patients were stratified according to the timing of biliary reconstruction with hepaticojejunostomy: early (day 0–7), intermediate (1–6 weeks) and late (6 weeks–6 months). Primary endpoint was re-intervention >90 days after the hepaticojejunostomy and secondary endpoints were severe 90-day complications and liver-related mortality. Results: In total 913 patients from 48 centers were included in the analysis. In 401 patients (44%) the bile duct injury was diagnosed intraoperatively, and 126 patients (14%) suffered from concomitant vascular injury. In multivariable analysis the timing of hepaticojejunostomy had no impact on postoperative complications, the need for re-intervention after 90 days nor liver-related mortality. The rate of re-intervention more than 90 days after the hepaticojejunostomy was significantly increased in male patients but decreased in older patients. Severe co-morbidity increased the risk for liver-related mortality (HR 3.439; CI 1.37–8.65; p = 0.009). Conclusion: After BDI occurring during cholecystectomy, the timing of biliary reconstruction with hepaticojejunostomy did not have any impact on severe postoperative complications, the need for re-intervention or liver-related mortality. Individualised treatment after iatrogenic bile duct injury is still advisable.
Published: 2019
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30. Post cholecystectomy bile duct injury: early, intermediate or late repair with hepaticojejunostomy – an E-AHPBA multi-center study

Author: Rystedt, J. M. L., Kleeff, J., Salvia, R., Besselink, M. G., Prasad, R., Lesurtel, M., Sturesson, C., Abu Hilal, M., Aljaiuossi, A., Antonucci, A., Ardito, Francesco, Ausania, F., Bernon, M., Berrevoet, F., Bjornsson, B., Bonsing, B. A., Boonstra, E. A., Bracke, B., Brusadin, R., Burda, L., Caraballo, M., Casellas-Robert, M., Coker, A., Davide, J., De Gelder, A., De Rose, A. M., Djokic, M., Dudek, K., Ekmekcigil, E., Filauro, M., Fulop, A., Gallagher, T., Gastaca, M., Gefen, R., Giuliante, Felice, Habibeh, H., Halle-Smith, J., Haraldsdottir, K. H., Hartman, V., Hauer, A., Hemmingsson, O., Hoskovec, D., Isaksson, B., Jonas, E., Khalaileh, A., Klug, R., Krige, J., Lignier, D., Lindemann, J., Lopez-Lopez, V., Lucidi, V., Mabrut, J. -Y., Mansson, C., Mieog, S., Mirza, D. F., Oldhafer, K. J., Omoshoro-Jones, J. A. O., Ortega-Torrecilla, N., Otto, W., Panaro, F., Pando, E., Paterna-Lopez, S., Pekmezci, S., Pesce, A., Porte, R. J., Poves, I., Prieto Calvo, M., Primavesi, F., Puleo, S., Recordare, A., Rizell, M., Roberts, K., Robles-Campos, R., Sanchiz-Cardenas, E., Sandstrom, P., Saribeyoglu, K., Schauer, M., Schreuder, M., Siriwardena, A. K., Smith, M. D., Sousa Silva, D., Sparrelid, E., Stattner, S., Stavrou, G. A., Straka, M., Stromberg, C., Sutcliffe, R. P., Szijarto, A., Taflin, H., Trotovsek, B., van Gulik, T., Wallach, N., Zieniewicz, K., Ardito F. (ORCID:0000-0003-1596-2862), Giuliante F. (ORCID:0000-0001-9517-8220), Rystedt, J. M. L., Kleeff, J., Salvia, R., Besselink, M. G., Prasad, R., Lesurtel, M., Sturesson, C., Abu Hilal, M., Aljaiuossi, A., Antonucci, A., Ardito, Francesco, Ausania, F., Bernon, M., Berrevoet, F., Bjornsson, B., Bonsing, B. A., Boonstra, E. A., Bracke, B., Brusadin, R., Burda, L., Caraballo, M., Casellas-Robert, M., Coker, A., Davide, J., De Gelder, A., De Rose, A. M., Djokic, M., Dudek, K., Ekmekcigil, E., Filauro, M., Fulop, A., Gallagher, T., Gastaca, M., Gefen, R., Giuliante, Felice, Habibeh, H., Halle-Smith, J., Haraldsdottir, K. H., Hartman, V., Hauer, A., Hemmingsson, O., Hoskovec, D., Isaksson, B., Jonas, E., Khalaileh, A., Klug, R., Krige, J., Lignier, D., Lindemann, J., Lopez-Lopez, V., Lucidi, V., Mabrut, J. -Y., Mansson, C., Mieog, S., Mirza, D. F., Oldhafer, K. J., Omoshoro-Jones, J. A. O., Ortega-Torrecilla, N., Otto, W., Panaro, F., Pando, E., Paterna-Lopez, S., Pekmezci, S., Pesce, A., Porte, R. J., Poves, I., Prieto Calvo, M., Primavesi, F., Puleo, S., Recordare, A., Rizell, M., Roberts, K., Robles-Campos, R., Sanchiz-Cardenas, E., Sandstrom, P., Saribeyoglu, K., Schauer, M., Schreuder, M., Siriwardena, A. K., Smith, M. D., Sousa Silva, D., Sparrelid, E., Stattner, S., Stavrou, G. A., Straka, M., Stromberg, C., Sutcliffe, R. P., Szijarto, A., Taflin, H., Trotovsek, B., van Gulik, T., Wallach, N., Zieniewicz, K., Ardito F. (ORCID:0000-0003-1596-2862), and Giuliante F. (ORCID:0000-0001-9517-8220)
Abstract: Background: Treatment of bile duct injuries (BDI) during cholecystectomy depends on the severity of injury and the timing of diagnosis. Standard of care for severe BDIs is hepaticojejunostomy. The aim of this retrospective multi-center study was to assess the optimal timing for repair of BDI with hepaticojejunostomy. Methods: Members of the European-African HepatoPancreatoBiliary Association were invited to report all consecutive patients with hepaticojejunostomy after BDI from January 2000 to June 2016. Patients were stratified according to the timing of biliary reconstruction with hepaticojejunostomy: early (day 0–7), intermediate (1–6 weeks) and late (6 weeks–6 months). Primary endpoint was re-intervention >90 days after the hepaticojejunostomy and secondary endpoints were severe 90-day complications and liver-related mortality. Results: In total 913 patients from 48 centers were included in the analysis. In 401 patients (44%) the bile duct injury was diagnosed intraoperatively, and 126 patients (14%) suffered from concomitant vascular injury. In multivariable analysis the timing of hepaticojejunostomy had no impact on postoperative complications, the need for re-intervention after 90 days nor liver-related mortality. The rate of re-intervention more than 90 days after the hepaticojejunostomy was significantly increased in male patients but decreased in older patients. Severe co-morbidity increased the risk for liver-related mortality (HR 3.439; CI 1.37–8.65; p = 0.009). Conclusion: After BDI occurring during cholecystectomy, the timing of biliary reconstruction with hepaticojejunostomy did not have any impact on severe postoperative complications, the need for re-intervention or liver-related mortality. Individualised treatment after iatrogenic bile duct injury is still advisable.
Published: 2019

31. Laser-excited fluorescence spectra of eastern SPF wood species. An optical technique for identification and separation of wood species?

Author: Sum, S. T., Singleton, D. L., Paraskevopoulos, G., Irwin, R. S., Barbour, R. J., and Sutcliffe, R.
Published: 1991
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32. Sticker stain formation in hardwoods: Isolation of scopoletin from sugar maple (Acer saccharum Marsh.)

Author: Miller, D., Sutcliffe, R., and Thauvette, J.
Published: 1990
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33. Evaluation of the clinical and economic impact of delays to surgery in patients with periampullary cancer

Author: Pandé, R., primary, Hodson, J., additional, Murray, A., additional, Marcon, F., additional, Kalisvaart, M., additional, Marudanayagam, R., additional, Sutcliffe, R. P., additional, Mirza, D. F., additional, Isaac, J., additional, and Roberts, K. J., additional
Published: 2019
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34. Regional chromosomal assignment of human 3-beta-hydroxy-5-ene steroid dehydrogenase to 1p13.1 by non-isotopic in situ hybridisation

Author: Morrison, N., Nickson, D. A., McBride, M. W., Mueller, U. W., Boyd, E., and Sutcliffe, R. G.
Published: 1991
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35. Development and multicentre validation of a prognostic model to predict resectability of pancreatic head malignancy

Author: Gerken, K., primary, Roberts, K. J., additional, Reichert, B., additional, Sutcliffe, R. P., additional, Marcon, F., additional, Kamarajah, S. K., additional, Kaltenborn, A., additional, Becker, T., additional, Heits, N. G., additional, Mirza, D. F., additional, Klempnauer, J., additional, and Schrem, H., additional
Published: 2018
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36. Optimized protocols for typing 75 microsatellite loci in AS, PVG, F344, and BN rats

Author: Shiels, P., Alonso, M. B. Durán, Davison, A. O., Heeley, R. P., Dominiczak, A. F., Payne, A. P., Davies, R. W., and Sutcliffe, R. G.
Published: 1995
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37. Petrology of middle proterozoic diabases and picrites from Lake Nipigon, Canada

Author: Sutcliffe, R. H.
Published: 1987
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38. Selective solubilization of xylan in pulp using a purified xylanase fromTrichoderma harzianum

Author: Senior, D. J., Mayers, P. P., Miller, D., Sutcliffe, R., Tan, L., and Saddler, J. N.
Published: 1988
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39. Group-specific component phenotyping by antibody-antigen crossed electrophoresis

Author: Sutcliffe, R. G. and Brock, D. J. H.
Published: 1973
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40. Predictability in meteorology

Author: Sutcliffe, R. C.
Published: 1954
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41. PTU-077 Unplanned hospital readmission within 30 days after liver and pancreatic resection

Author: Neo, E L, primary, Viñuela, E, additional, Bramhall, S R, additional, Isaac, J, additional, Marudanayagam, R, additional, Mayer, D, additional, Mirza, D F, additional, Muiesan, P, additional, and Sutcliffe, R P, additional
Published: 2012
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42. Colorectal liver metastases

Author: Sutcliffe, R. P., primary and Bhattacharya, S., additional
Published: 2011
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43. Spontaneous perforation of cervical oesophagus: a rare variant of Boerhaave's syndrome

Author: Mittal, S, primary, Rohatgi, A, additional, Sutcliffe, R P, additional, and Botha, A, additional
Published: 2009
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44. A randomised trial comparing tamoxifen vs. surgery in patients over the age of 70 with operable breast cancer - Final results after 28 years of follow-up.

Author: Gazet, J.-C. and Sutcliffe, R.
Subjects: BREAST cancer treatment, RANDOMIZED controlled trials, TAMOXIFEN, ONCOLOGIC surgery, FOLLOW-up studies (Medicine), CANCER relapse
Abstract: Abstract: A final review of a historical trial commenced in 1982 comprising 200 patients aged 70 or over with operable breast cancer randomised to surgery or tamoxifen with crossover on recurrence has shown that at 21–28 years follow-up,all have died from verified causes. 43 in the surgical arm and 40 in the Tamoxifen arm died of breast cancer (41.5% in total). 117 patients (58.5%) died of other verified causes unrelated to breast cancer. These patients in effect achieved a cure from breast cancer. The survival curves for both those treated by surgery or Tamoxifen are similar as are the associated curves comparing deaths from breast cancer and other causes. However although 50% of deaths from breast cancer occurred within the first five years of follow-up, further deaths from breast cancer occurred up to 25 years later. Thus at long term follow-up in a highly selected and favourable group of patients recurrence and death from breast cancer still occurred. This confirms the view that at no time in the post treatment period can one state that any patient is cured of breast cancer. However with favourable patient presentation and optimal current treatment there is a high probability that in a significant number of patients a personal cure will be achieved as described by Brinkley and Haybittle. [Copyright &y& Elsevier]
Published: 2011
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45. TRANSHIATAL OESOPHAGECTOMY: TECHNIQUES, TIPS AND OUTCOMES.

Author: Rohatgi, A., Forshaw, M. J., Sutcliffe, R. P., Strauss, D. C., and Mason, R. C.
Subjects: ESOPHAGECTOMY, ESOPHAGEAL surgery, SURGICAL complications, CHYLE, ABSORPTION (Physiology), LYMPHATICS
Abstract: Aim: To demonstrate our technique and valuable tips for transhiatal oesophagectomies. Method: 215 patients underwent transhiatal oesophagectomies in our unit between 2000 and 2006. Results: In-hospital mortality was 0.9%. Anastomotic leak in 12 patients (5.6%). Chyle leak was seen in five patients and recurrent nerve neuropraxia in six patients. Iatrogenic splenectomy rate was 6%. The median operative time was 151 minutes (range 93-276 minutes). Overall median length of hospital stay was 15 days (range 8-95 days). The median survival for all patients undergoing transhiatal oesophagectomy for invasive malignancy was 42.9 months and the one-year and five-year survival were 81% and 48% respectively. Conclusion: This is a safe and oncologically sound procedure. We feel that the tips can be helpful for anyone performing this procedure. [ABSTRACT FROM AUTHOR]
Published: 2008
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46. Training in oesophageal surgery – The gold standard: A prospective study.

Author: Rohatgi, A., Sutcliffe, R., Forshaw, M.J., Strauss, D., and Mason, R.C.
Subjects: ESOPHAGEAL stenosis, SURGICAL excision, LYMPH nodes, MEDICAL care
Abstract: Abstract: Introduction: Competency in complex oesophagogastric surgery, within the current climate of changes to medical training and reduced hours, requires repeated, focused, hands-on training. We describe the training methods for oesophagectomy in our institution. Methods: All oesophageal resections under the care of one consultant surgeon are regarded as training cases. When trainees start they are shown the first resection; subsequently, the trainees then perform every case with the consultant scrubbed. Consultant input consists of retraction and tips in difficult situations. All data were collected on a prospective database. Results: Two hundered and seventy patients (215 males, median age=64 years) underwent primary oesophagectomy under the consultant, between January 2000 and May 2007. Fifteen resections (6%) were performed solely by the consultant. ASA grading was: I=15, II=154, III=95, IV=5, and unrecorded=1. In-hospital mortality and clinically apparent leak rate was 1.9% (5 deaths) and 6.2% (n =17), respectively. Reoperation was required in 15 patients (5.5%). The median length of hospital stay was 14 days (range=8–95 days). Median lymph node yield was 13 (range=0–64). Conclusions: Trainees under supervision can competently perform an oesophagectomy without compromising patient care. An early hands-on approach leads to a rapid ascent of the learning curve and is essential in today''s climate of limited training opportunity. [Copyright &y& Elsevier]
Published: 2008
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47. A Rat Embryo Staging Scale for the Generation of Donor Tissue for Neural Transplantation

Author: Torres, E. M., Weyrauch, U. M., Sutcliffe, R., and Dunnett, S. B.
Abstract: In rat models of Parkinson's and Huntington's diseases, embryonic neural cells obtained from embryos of specified ages can be implanted into the brain to partially restore both physiology and function. However, in litters produced using overnight mating protocols (often from commercial suppliers), the embryonic age can be difficult to determine precisely. As a result, embryonic size based on crown to rump length (CRL) is usually a more reliable method of embryo staging than the day of mating. This approach is not without difficulty. There are a number of rat staging scales in the literature, none of which deal with donor ages younger than E13, and there are discrepancies between scales at some donor ages. In the present article, we have devised a short mating-period protocol to produce precisely aged embryos. We show that CRL is a highly accurate, reproducible index of donor age and we present an updated embryonic staging scale for Sprague-Dawley (CD) rats that includes donor ages younger than those previously reported.
Published: 2008
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48. Palaeoproterozoic Ni–Cu–PGE mineralisation in the Shakespeare intrusion, Ontario, Canada: A new style of Nipissing gabbro-hosted mineralisation

Author: Sproule, R. A., Sutcliffe, R., Tracanelli, H., and Lesher, C. M.
Abstract: The 2217 Ma Shakespeare intrusion is part of the extensive 2˙2 Ga Nipissing gabbro suite and is hosted within 2˙45–2˙2 Ga Huronian Supergroup metasediments in the Southern Province of the Canadian Shield, close to the border with the Superior Province. The Shakespeare intrusion is a complex differentiated sill approximately 14 km in strike length and approximately 300 to 430 in thickness. It comprises two distinct magmatic packages: (a) a Lower Group composed of unmineralised pyroxenite and gabbro, and (b) an Upper Group composed of Ni–Cu–PGE mineralised melagabbro, quartz gabbro, and biotite quartz gabbro-diorite. The Shakespeare intrusion formed from a tholeiitic parental magma. All of the rocks in the intrusion are enriched in highly incompatible lithophile elements (HILE: Cs, Rb, U, Th, Nb, Ta, LREE) relative to moderately incompatible lithophile elements (MILE: Zr, Ti, HREE) and are strongly depleted in Nb and Ti relative to elements of similar incompatibility. These geochemical characteristics suggest that the Shakespeare magma underwent extensive degrees of upper crustal contamination before emplacement. Although other parts of the Nipissing gabbro suite exhibit similar geochemical characteristics, the Shakespeare intrusion is more enriched in HILE and more strongly depleted in Nb–Ti, and therefore appears to have undergone greater degrees of crustal contamination. Heavily disseminated to patchy net-textured (10–15%) Fe–Cu–Ni sulphides (pyrrhotite–chalcopyrite–pentlandite) occur in the upper portion of the melagabbro of the Upper Group, near and at the contact with the overlying quartz gabbro, and in melagabbro dykes. This is a new style of magmatic Ni–Cu–PGE mineralisation in the Nipissing gabbro suite. The mineralised zone contains abundant inclusions of quartzite, blue quartz eyes and rare diorite. The ores have compositions consistent with having been derived from the Shakespeare magma and to have equilibrated at moderate magma/sulphide ratios (R=500–1000). The Ni–Cu–PGE mineralisation in the Shakespeare deposit appears to have resulted from the following processes: (a) generation of Nipissing magmas via partial melting of mantle peridotite, (b) contamination of Nipissing magmas by continental crust during ascent, (c) introduction and crystallisation of contaminated but sulphide–undersaturated magmas into the Shakespeare intrusion, forming the Lower Group, (d) additional, apparently relatively local, crustal contamination and sulphide saturation resulting in the incorporation of abundant xenoliths of country rocks and the generation of moderate amounts of Ni–Cu–(PGE) sulphide melt, and, (e) introduction of the xenoliths and sulphide-bearing magma into the Shakespeare intrusion, forming the Upper Group, with heavier sulphides settling at the base of the new crystallisation floor, resulting in low-moderate Rfactor values.
Published: 2007
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49. Uses and limitations of quantitative structure-activity relationships (QSARs) to categorize substances on the Canadian domestic substance list as persistent and/or bioaccumulative, and inherently toxic to non-human organisms

Author: MacDonald, D., Breton, R., Sutcliffe, R., and Walker, J.
Abstract: Under sections 73 and 74 of the revised Canadian Environmental Protection Act (CEPA 1999) , Environment Canada and Health Canada must "categorize" and "screen" about 23,000 substances on the Domestic Substances List (DSL) for persistence (P), bioaccumulation (B), and inherently toxic (iT) properties. Since experimental data for P, B and iT are only available for a few DSL substances, a workshop was held to address issues associated with the use of Quantitative Structure-Activity Relationships (QSARs) to categorize these substances. This paper describes the results of an 11-12 November 1999 International Workshop sponsored by Environment Canada to discuss potential uses and limitations of QSARs to categorize DSL substances as either persistent or bioaccumulative and iT to non-human organisms and to recommend future research needed to develop methods for predicting the P, B and iT of difficult-to-model substances.
Published: 2002
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50. The AS/AGU rat: a spontaneous model of disruption and degeneration in the nigrostriatal dopaminergic system

Author: PAYNE, A. P., CAMPBELL, J. M., RUSSELL, D., FAVOR, G., SUTCLIFFE, R. G., BENNETT, N. K., DAVIES, R. W., and STONE, T. W.
Abstract: The AS/AGU rat provides an alternative to experimentally produced laboratory models of basal ganglia disorders. This mutant is characterised by disturbances of movement including clumsy gait, whole body tremor, rigidity and difficulty in initiating movement. From an early age, there is a profound depletion of extracellular dopamine in the dorsal caudate‐putamen as measured via in vivo microdialysis; levels are only 10–20% of those found in the parent Albino Swiss (AS) strain. Subsequently a depletion of whole tissue dopamine levels occurs and, later still, loss of dopaminergic cells in the substantia nigra pars compacta. The dysfunction in movement and the nigrostriatal dopaminergic system are clearly linked, since movement can be ameliorated by L‐DOPA administration. Furthermore, there are depletions in glucose utilisation in several regions of the basal ganglia circuitry, including the substantia nigra pars compacta, the subthalamic nucleus and the ventrolateral thalamus. The AS/AGU rat represents a unique opportunity to investigate the intrinsic factors controlling the integrity of dopaminergic systems and the recent successful positional cloning of the agu gene will allow the molecular mechanisms underlying this interesting phenotype to be analysed.
Published: 2000
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