Department of Hepatobiliary Surgery, The First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China.
Department of Liver Surgery & Liver Transplantation Center, Sichuan University West China Hospital, Chengdu 610041, Sichuan Province, China.
World J Gastroenterol. 2022 Jul 7;28(25):2968-2980. doi: 10.3748/wjg.v28.i25.2968.
Laparoscopic liver resection (LLR) has become a safe surgical procedure that needs additional summarization.
To review 4 years of total LLR surgeries, exceeding 1000 cases, which were performed at a single center.
Patients who underwent LLR at West China Hospital of Sichuan University between January 2015 and December 2018 were identified. Surgical details, including the interventional year, category of liver disease, and malignant liver tumors prognosis, were evaluated. The learning curve for LLR was evaluated using the cumulative sum method. The Kaplan-Meier method was used to perform survival analysis.
Ultimately, 1098 patients were identified. Hepatocellular carcinoma (HCC) was the most common disease that led to the need for LLR at the center ( = 462, 42.08%). The average operation time was 216.94 ± 98.51 min. The conversion rate was 1.82% (20/1098). The complication rate was 9.20% (from grade II to V). The 1-year and 3-year overall survival rates of HCC patients were 89.7% and 81.9%, respectively. The learning curve was grouped into two phases for local resection (cases 1-106 and 107-373), three phases for anatomical segmentectomy (cases 1-44, 45-74 and 75-120), and three phases for hemihepatectomy (cases 1-17, 18-48 and 49-88).
LLR may be considered a first-line surgical intervention for liver resection that can be performed safely for a variety of primary, secondary, and recurrent liver tumors and for benign diseases once technical competence is proficiently attained.
腹腔镜肝切除术（LLR）已成为一种安全的手术方法，需要进一步总结。
回顾在四川大学华西医院单中心进行的超过 1000 例 4 年的 LLR 手术。
确定 2015 年 1 月至 2018 年 12 月期间在华西医院接受 LLR 的患者。评估手术细节，包括介入年份、肝病类别和恶性肝肿瘤预后。使用累积和方法评估 LLR 的学习曲线。使用 Kaplan-Meier 方法进行生存分析。
最终确定了 1098 例患者。肝癌（HCC）是导致该中心需要进行 LLR 的最常见疾病（=462，42.08%）。平均手术时间为 216.94±98.51 分钟。转化率为 1.82%（20/1098）。并发症发生率为 9.20%（从 II 级到 V 级）。HCC 患者的 1 年和 3 年总生存率分别为 89.7%和 81.9%。学习曲线分为局部切除术（病例 1-106 和 107-373）两个阶段、解剖性肝段切除术（病例 1-44、45-74 和 75-120）三个阶段和半肝切除术（病例 1-17、18-48 和 49-88）三个阶段。
一旦熟练掌握了技术，LLR 可被视为原发性、继发性和复发性肝脏肿瘤以及良性疾病的一线肝切除术干预措施，其安全性较高。
