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Initial laparoscopic liver resection is associated with reduced adhesions and transfusions at the time of salvage liver transplantation.
- Source :
-
HPB : the official journal of the International Hepato Pancreato Biliary Association [HPB (Oxford)] 2024 Sep; Vol. 26 (9), pp. 1190-1199. Date of Electronic Publication: 2024 Jun 10. - Publication Year :
- 2024
-
Abstract
- Background: Laparoscopic liver resection (LLR) has been associated with improved patient recovery as well as reduced postoperative adhesions compared to open LR (OLR) and could therefore facilitate redo liver surgery. LLR prior to liver transplantation (LT) is increasingly performed, LT being saved for HCC recurrence. LT is still performed by open surgery due to vascular reconstructions and underlying liver chronic disease. We evaluated the impact of laparoscopic approach for LR prior to LT in terms of intraoperative transfusions, adhesions severity and outcome.<br />Methods: Data from all patients who underwent a LT after LR in two French high-volume tertiary centers were retrospectively reviewed. The impact of LLR on per operative and postoperative outcome was assessed using logistic regression.<br />Results: 170 patients were included, 43 patients in the LLR group and 127 in the OLR group. Preoperative characteristics were comparable between both groups, except LLR group included more patients with "very early-stage" BCLC tumors than OLR group (51% vs. 33%, p = 0.02) and less anatomical resections (54% vs. 75%, p = 0.015). During LT, the transfusion rate was significantly higher in the OLR group (71.4% vs 44.2%, p = 0.002) as well as the proportion of type III adhesions according to OLSG classification (p < 0.001). Multivariate analysis found LLR to be an independent protective factor for adhesions and transfusion (p = 0.001 and p = 0.03 respectively).<br />Conclusion: Laparoscopic liver resection was associated with reduced postoperative adhesions and transfusion requirements during subsequent liver transplantation.<br />Competing Interests: Conflicts of interest None to declare.<br /> (Copyright © 2024 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.)
- Subjects :
- Humans
Male
Female
Middle Aged
Retrospective Studies
Tissue Adhesions
Aged
Treatment Outcome
Time Factors
Risk Factors
Salvage Therapy
France
Postoperative Complications etiology
Laparoscopy adverse effects
Liver Transplantation adverse effects
Liver Transplantation methods
Hepatectomy methods
Hepatectomy adverse effects
Blood Transfusion statistics & numerical data
Liver Neoplasms surgery
Liver Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1477-2574
- Volume :
- 26
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- HPB : the official journal of the International Hepato Pancreato Biliary Association
- Publication Type :
- Academic Journal
- Accession number :
- 38944570
- Full Text :
- https://doi.org/10.1016/j.hpb.2024.06.001