Published online Jul 7, 2022. doi: 10.3748/wjg.v28.i25.2968
Peer-review started: January 4, 2022
First decision: March 9, 2022
Revised: April 1, 2022
Accepted: May 27, 2022
Article in press: May 27, 2022
Published online: July 7, 2022
Processing time: 181 Days and 10 Hours
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 (n = 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.
Core Tip: West China Hospital of Sichuan University is the biggest and most advanced one in the western region of China. About 1500-2500 cases of liver resection have been performed in our center every year. Since the first laparoscopic liver resection (LLR) was performed in 2015, we have accumulated more than 1000 cases rapidly, including hemi-hepatectomy, mesohepatectomy, anatomical segmentectomy from segment I to VIII and even the first case of laparoscopic donor hepatectomy in Mainland China. In this study, we want to share our experiences and introduce technical innovation of LLR.