Pagina Iniziale » Fegato » Interventi Chirurgici sul Fegato » Resezioni Epatiche Robotiche
Resezioni Epatiche Robotiche
L’esecuzione di una resezione del fegato per via mini-invasiva con tecnica robotica è oggi la maniera più avanzata per la conduzione di questo difficile intervento.
Nel 1997 Himpens ha pubblicato la prima applicazione clinica di telerobotica condotta con successo. Il gruppo aveva eseguito una colecistectomia laparoscopica usando un prototipo del robot “da Vinci”
Questo sistema consentiva al chirurgo, fra l’altro, di rimanere seduto per interventi che duravano parecchio tempo, consentiva una visione del campo chirurgico in tre dimensioni, una correlazione con le immagini prodotte dalla radiologia pre-operatoria in tempo reale e la possibilità di eseguire suture in maniera assai semplice.
Da allora, molte procedure chirurgiche sono state eseguite usando robot chirurgici, fra cui la colecistectomia, la fundoplicatio secondo Nissen, la miotomia secondo Heller, il by-pass gastrico alla Roux e infine interventi maggiori di chirurgia colorettale.
I vantaggi dei movimenti consentiti dagli strumenti del robot chirurgico, che simulano quelli del polso del braccio dell’uomo
Anche se la chirurgia laparoscopica già si associava con i benefici dell’approccio mini-invasivo, la laparoscopia pura resta tutt’oggi gravata da
- un limitato grado di manipolazione con gli strumenti,
- dall’effetto fulcro all’ingresso dei trocar,
- dall’amplificazione del tremore delle mani,
- dalla scarsa ergonomia e
- dalla limitata visualizzazione bidimensionale.
Il sistema chirurgico robotizzato fornisce soluzioni a queste limitazioni.
Fra tutte, la più importante è la tecnologia EndoWrist dei suoi strumenti, che offre al chirurgo 7 gradi di libertà, permettendo
- di eseguire suture in maniera assai semplice anche in spazi difficili da raggiungere,
- di filtrare il tremore delle mani,
- di avere una visualizzazione ottica del campo operatorio in tridimensionale ed
- una eccellente ergonomia.
Nel campo della chirurgia del fegato e delle vie biliari, è stato inizialmente descritto l’uso del sistema chirurgico robotico durante resezioni epatiche solo per l’isolamento degli elementi del peduncolo e per l’inizio della resezione epatica vera e propria.
Da allora, sono state pubblicate diverse casistiche di singoli centri che hanno riportato la fattibilità della procedura, la sua sicurezza, il basso tasso di “conversione” a procedura ad addome aperto, ridotte perdite ematiche e un tasso di complicanze post-operatorie assai contenuto.
La prima serie italiana, e forse mondiale, di resezioni epatiche robotiche è stata eseguita da Giulianotti, all’ospedale di Grosseto ed è iniziata nel marzo del 2002.
Il posizionamento del Robot chirurgico “da Vinci” durante un intervento di chirurgia addominale
Schema dall’alto del posizionamento della consolle del robot e del paziente durante un intervento robotico
Durante una resezione epatica eseguita con il robot (come per tutte le altre procedure eseguite con la tecnica robotica), il chirurgo siede alla consolle posta a distanza dal paziente e con le mani ed i piedi manovra i comandi, per muovere in maniera appropriata gli strumenti e per eseguire i movimenti previsti per l’esecuzione dell’intervento programmato.
Il robot chirurgico non sostituisce quindi il chirurgo nell’esecuzione dell’operazione.
E’ soltanto uno strumento nelle sue mani per effettuare l’intervento chirurgico stesso.
VANTAGGI DELLA CHIRURGIA EPATICA ROBOTICA
- L’ergonomia sfavorevole dei rigidi strumenti laparoscopici viene parzialmente superata dagli strumenti articolati del robot, che simulano i movimenti delle mani. Questo consente di raggiungere ed eseguire suture chirurgiche con angolature non permesse tecnicamente dalla rigidità della laparoscopia.
- Il tremore della mani è filtrato dagli strumenti robotici e consente quindi l’esecuzione di gesti più precisi.
- L’uso della consolle a distanza consente al chirurgo di operare seduto, in una posizione assai comoda.
- La visione in 3 dimensioni fa superare almeno parzialmente la mancanza del senso della profondità.
- Il chirurgo ha il completo controllo della telecamera, che è montata in una posizione stabile e non risente dei movimenti degli assistenti.
- I divaricatori laparoscopici sono anch’essi sotto il controllo del chirurgo.
- La curva di apprendimento per il chirurgo è più breve rispetto a quella della laparoscopia convenzionale.
- Il posizionamento dei trocar è più gestibile rispetto al fulcro provocato dalla laparoscopia.
- La tecnica ad addome aperto viene translata più facilmente nella tecnica robotica rispetto alla tecnica laparoscopica.
- E’ possibile utilizzare per l’apprendimento sistemi di addestramento computerizzato simili a quelli usati per la simulazione di volo degli aerei..
SVANTAGGI DELLA CHIRURGIA EPATICA ROBOTICA
- La generazione di robot che è entrata per prima sul mercato ha braccia molto larghe, che si aggiungono al volume della console nel computo dello spazio richiesto. Sono quindi necessarie sale operatorie grandi e vi è sempre il rischio che le braccia del robot entrino in conflitto fra di loro.
- E’ richiesto l’aiuto di un primo assistente che sia ben preparato nella procedura laparoscopica e nelle procedure di chirurgia del fegato.
- Non vi è la sensazione del tatto, che può portare a gesti inappropriati in particolare con strutture anatomiche fragili e compromettere l’esecuzione di suture con fili particolarmente delicati.
- Il cambiamento di campo operatorio con i robot di prima generazione richiede lo smontaggio ed il riposizionamento dello strumento, con inevitabile perdita di tempo.
- Non tutti i centri hanno a disposizione una sonda per l’ecografia intraoperatoria che possa essere gestita direttamente dal chirurgo dalla consolle.
- La velocità nella conversione a procedura ad addome aperto per l’insorgenza di complicanze intraoperatorie impreviste può essere rallentata a causa della distanza del chirurgo dal paziente e dalla necessità di smontare il robot.
- Gli interventi eseguiti con il robot occupano più tempo di sala operatoria a causa della messa a punto e del montaggio del robot stesso.
- Il robot è una macchina e può avere dei malfunzionamenti.
- Il robot costa molti soldi ed ha dei costi di gestione molto elevati.
La prima serie di resezioni epatiche robotiche condotte all’UOC di Chirurgia EpatoBilioPancreatica dell’IFO – Istituto Nazionale Tumori “Regina Elena” IRCCS, in Roma, è stata pubblicata nel 2020
Quali interventi chirurgici si realizzano sul fegato?
Il tipo di intervento da eseguire dipende da molti fattor
Le resezioni epatiche
Una descrizione schematica della tipologia di resezioni epatiche eseguibili.
- Ultimo aggiornamento della pagina: 03/10/2023
Linee Guida per la Chirurgia Epatobiliare
2023
Primavesi F; Maglione M; Cipriani F; Denecke T; Oberkofler C E; Starlinger P; Dasari B V M; Heil J; Sgarbura O; Søreide K; Diaz-Nieto R; Fondevila C; Frampton A E; Geisel D; Henninger B; Hessheimer A J; Lesurtel M; Mole D; Öllinger R; Olthof P; Reiberger T; Schnitzbauer A A; Schwarz C; Sparrelid E; Stockmann M; Truant S; Aldrighetti L; Braunwarth E; D'Hondt M; DeOliveira M L; Erdmann J; Fuks D; Gruenberger T; Kaczirek K; Malik H; Öfner D; Rahbari N N; Göbel G; Siriwardena A K; Stättner S
E-AHPBA-ESSO-ESSR Innsbruck consensus guidelines for preoperative liver function assessment before hepatectomy Journal Article
In: Br. J. Surg., 2023.
@article{Primavesi2023-he,
title = {E-AHPBA-ESSO-ESSR Innsbruck consensus guidelines for preoperative liver function assessment before hepatectomy},
author = {Florian Primavesi and Manuel Maglione and Federica Cipriani and Timm Denecke and Christian E Oberkofler and Patrick Starlinger and Bobby V M Dasari and Jan Heil and Olivia Sgarbura and Kjetil Søreide and Rafael Diaz-Nieto and Constantino Fondevila and Adam E Frampton and Dominik Geisel and Benjamin Henninger and Amelia J Hessheimer and Mickaël Lesurtel and Damian Mole and Robert Öllinger and Pim Olthof and Thomas Reiberger and Andreas A Schnitzbauer and Christoph Schwarz and Ernesto Sparrelid and Martin Stockmann and Stéphanie Truant and Luca Aldrighetti and Eva Braunwarth and Mathieu D'Hondt and Michelle L DeOliveira and Joris Erdmann and David Fuks and Thomas Gruenberger and Klaus Kaczirek and Hassan Malik and Dietmar Öfner and Nuh N Rahbari and Georg Göbel and Ajith K Siriwardena and Stefan Stättner},
url = {https://academic.oup.com/bjs/article-lookup/doi/10.1093/bjs/znad233},
doi = {10.1093/bjs/znad233},
year = {2023},
date = {2023-08-01},
urldate = {2023-08-01},
journal = {Br. J. Surg.},
publisher = {Oxford University Press (OUP)},
abstract = {BACKGROUND: Posthepatectomy liver failure (PHLF) contributes
significantly to morbidity and mortality after liver surgery.
Standardized assessment of preoperative liver function is
crucial to identify patients at risk. These European consensus
guidelines provide guidance for preoperative patient assessment.
METHODS: A modified Delphi approach was used to achieve
consensus. The expert panel consisted of hepatobiliary surgeons,
radiologists, nuclear medicine specialists, and hepatologists.
The guideline process was supervised by a methodologist and
reviewed by a patient representative. A systematic literature
search was performed in PubMed/MEDLINE, the Cochrane library,
and the WHO International Clinical Trials Registry. Evidence
assessment and statement development followed Scottish
Intercollegiate Guidelines Network methodology. RESULTS: Based
on 271 publications covering 4 key areas, 21 statements (at
least 85 per cent agreement) were produced (median level of
evidence 2- to 2+). Only a few systematic reviews (2++) and one
RCT (1+) were identified. Preoperative liver function assessment
should be considered before complex resections, and in patients
with suspected or known underlying liver disease, or
chemotherapy-associated or drug-induced liver injury. Clinical
assessment and blood-based scores reflecting liver function or
portal hypertension (for example albumin/bilirubin, platelet
count) aid in identifying risk of PHLF. Volumetry of the future
liver remnant represents the foundation for assessment, and can
be combined with indocyanine green clearance or
LiMAx® according to local expertise and
availability. Functional MRI and liver scintigraphy are
alternatives, combining FLR volume and function in one
examination. CONCLUSION: These guidelines reflect established
methods to assess preoperative liver function and PHLF risk, and
have uncovered evidence gaps of interest for future research.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Posthepatectomy liver failure (PHLF) contributes
significantly to morbidity and mortality after liver surgery.
Standardized assessment of preoperative liver function is
crucial to identify patients at risk. These European consensus
guidelines provide guidance for preoperative patient assessment.
METHODS: A modified Delphi approach was used to achieve
consensus. The expert panel consisted of hepatobiliary surgeons,
radiologists, nuclear medicine specialists, and hepatologists.
The guideline process was supervised by a methodologist and
reviewed by a patient representative. A systematic literature
search was performed in PubMed/MEDLINE, the Cochrane library,
and the WHO International Clinical Trials Registry. Evidence
assessment and statement development followed Scottish
Intercollegiate Guidelines Network methodology. RESULTS: Based
on 271 publications covering 4 key areas, 21 statements (at
least 85 per cent agreement) were produced (median level of
evidence 2- to 2+). Only a few systematic reviews (2++) and one
RCT (1+) were identified. Preoperative liver function assessment
should be considered before complex resections, and in patients
with suspected or known underlying liver disease, or
chemotherapy-associated or drug-induced liver injury. Clinical
assessment and blood-based scores reflecting liver function or
portal hypertension (for example albumin/bilirubin, platelet
count) aid in identifying risk of PHLF. Volumetry of the future
liver remnant represents the foundation for assessment, and can
be combined with indocyanine green clearance or
LiMAx® according to local expertise and
availability. Functional MRI and liver scintigraphy are
alternatives, combining FLR volume and function in one
examination. CONCLUSION: These guidelines reflect established
methods to assess preoperative liver function and PHLF risk, and
have uncovered evidence gaps of interest for future research.
significantly to morbidity and mortality after liver surgery.
Standardized assessment of preoperative liver function is
crucial to identify patients at risk. These European consensus
guidelines provide guidance for preoperative patient assessment.
METHODS: A modified Delphi approach was used to achieve
consensus. The expert panel consisted of hepatobiliary surgeons,
radiologists, nuclear medicine specialists, and hepatologists.
The guideline process was supervised by a methodologist and
reviewed by a patient representative. A systematic literature
search was performed in PubMed/MEDLINE, the Cochrane library,
and the WHO International Clinical Trials Registry. Evidence
assessment and statement development followed Scottish
Intercollegiate Guidelines Network methodology. RESULTS: Based
on 271 publications covering 4 key areas, 21 statements (at
least 85 per cent agreement) were produced (median level of
evidence 2- to 2+). Only a few systematic reviews (2++) and one
RCT (1+) were identified. Preoperative liver function assessment
should be considered before complex resections, and in patients
with suspected or known underlying liver disease, or
chemotherapy-associated or drug-induced liver injury. Clinical
assessment and blood-based scores reflecting liver function or
portal hypertension (for example albumin/bilirubin, platelet
count) aid in identifying risk of PHLF. Volumetry of the future
liver remnant represents the foundation for assessment, and can
be combined with indocyanine green clearance or
LiMAx® according to local expertise and
availability. Functional MRI and liver scintigraphy are
alternatives, combining FLR volume and function in one
examination. CONCLUSION: These guidelines reflect established
methods to assess preoperative liver function and PHLF risk, and
have uncovered evidence gaps of interest for future research.
Woodhouse B; Barreto S G; Soreide K; Stavrou G A; Teh C; Pitt H; Martino M D; Herman P; Lopez-Lopez V; Berrevoet F; Talamonti M; Mikhnevich M; Khatkov I; Webber L; Kaldarov A; Windsor J; Filho O P C; Koea J
A core set of quality performance indicators for HPB procedures: a global consensus for hepatectomy, pancreatectomy, and complex biliary surgery Journal Article
In: HPB, vol. 25, no 8, pp. 924 – 932, 2023, ISSN: 1365182X, (Cited by: 0).
@article{Woodhouse2023924,
title = {A core set of quality performance indicators for HPB procedures: a global consensus for hepatectomy, pancreatectomy, and complex biliary surgery},
author = {Braden Woodhouse and Savio G. Barreto and Kjetil Soreide and Gregor A. Stavrou and Catherine Teh and Henry Pitt and Marcello Di Martino and Paulo Herman and Victor Lopez-Lopez and Frederik Berrevoet and Mark Talamonti and Mikhail Mikhnevich and Igor Khatkov and Laurence Webber and Ayrat Kaldarov and John Windsor and Omero P. Costa Filho and Jonathan Koea},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85159262163&doi=10.1016%2fj.hpb.2023.04.009&partnerID=40&md5=1271251a4e05213ada1fcc73d2275b2b},
doi = {10.1016/j.hpb.2023.04.009},
issn = {1365182X},
year = {2023},
date = {2023-01-01},
urldate = {2023-01-01},
journal = {HPB},
volume = {25},
number = {8},
pages = {924 – 932},
publisher = {Elsevier B.V.},
abstract = {Background: Surgery for hepatopancreaticobiliary (HPB) conditions is performed worldwide. This investigation aimed to develop a set of globally accepted procedural quality performance indicators (QPI) for HPB surgical procedures. Methods: A systematic literature review generated a dataset of published QPI for hepatectomy, pancreatectomy, complex biliary surgery and cholecystectomy. Using a modified Delphi process, three rounds were conducted with working groups composed of self-nominating members of the International Hepatopancreaticobiliary Association (IHPBA). The final set of QPI was circulated to the full membership of the IHPBA for review. Results: Seven “core” indicators were agreed for hepatectomy, pancreatectomy, and complex biliary surgery (availability of specific services on site, a specialised surgical team with at least two certified HPB surgeons, a satisfactory institutional case volume, synoptic pathology reporting, undertaking of unplanned reintervention procedures within 90 days, the incidence of post-procedure bile leak and Clavien-Dindo grade ≥III complications and 90-day post-procedural mortality). Three further procedure specific QPI were proposed for pancreatectomy, six for hepatectomy and complex biliary surgery. Nine procedure-specific QPIs were proposed for cholecystectomy. The final set of proposed indicators were reviewed and approved by 102 IHPBA members from 34 countries. Conclusions: This work presents a core set of internationally agreed QPI for HPB surgery. © 2023 International Hepato-Pancreato-Biliary Association Inc.},
note = {Cited by: 0},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Background: Surgery for hepatopancreaticobiliary (HPB) conditions is performed worldwide. This investigation aimed to develop a set of globally accepted procedural quality performance indicators (QPI) for HPB surgical procedures. Methods: A systematic literature review generated a dataset of published QPI for hepatectomy, pancreatectomy, complex biliary surgery and cholecystectomy. Using a modified Delphi process, three rounds were conducted with working groups composed of self-nominating members of the International Hepatopancreaticobiliary Association (IHPBA). The final set of QPI was circulated to the full membership of the IHPBA for review. Results: Seven “core” indicators were agreed for hepatectomy, pancreatectomy, and complex biliary surgery (availability of specific services on site, a specialised surgical team with at least two certified HPB surgeons, a satisfactory institutional case volume, synoptic pathology reporting, undertaking of unplanned reintervention procedures within 90 days, the incidence of post-procedure bile leak and Clavien-Dindo grade ≥III complications and 90-day post-procedural mortality). Three further procedure specific QPI were proposed for pancreatectomy, six for hepatectomy and complex biliary surgery. Nine procedure-specific QPIs were proposed for cholecystectomy. The final set of proposed indicators were reviewed and approved by 102 IHPBA members from 34 countries. Conclusions: This work presents a core set of internationally agreed QPI for HPB surgery. © 2023 International Hepato-Pancreato-Biliary Association Inc.
2022
Wakabayashi G; Cherqui D; Geller D A; Hilal M A; Berardi G; Ciria R; Abe Y; Aoki T; Asbun H; Chan A C Y; Chanwat R; Chen K; Chen Y; Cheung T T; Fuks D; Gotohda N; Han H; Hasegawa K; Hatano E; Honda G; Itano O; Iwashita Y; Kaneko H; Kato Y; Kim J; Liu R; López-Ben S; Morimoto M; Monden K; Rotellar F; Sakamoto Y; Sugioka A; Yoshiizumi T; Akahoshi K; Alconchel F; Ariizumi S; Cacciaguerra A B; Durán M; Vazquez A G; Golse N; Miyasaka Y; Mori Y; Ogiso S; Shirata C; Tomassini F; Urade T; Wakabayashi T; Nishino H; Hibi T; Kokudo N; Ohtsuka M; Ban D; Nagakawa Y; Ohtsuka T; Tanabe M; Nakamura M; Tsuchida A; Yamamoto M
The Tokyo 2020 terminology of liver anatomy and resections: Updates of the Brisbane 2000 system Journal Article
In: Journal of Hepato-Biliary-Pancreatic Sciences, vol. 29, no 1, pp. 6 – 15, 2022, ISSN: 18686974, (Cited by: 6).
@article{Wakabayashi20226,
title = {The Tokyo 2020 terminology of liver anatomy and resections: Updates of the Brisbane 2000 system},
author = {Go Wakabayashi and Daniel Cherqui and David A. Geller and Mohammed Abu Hilal and Giammauro Berardi and Ruben Ciria and Yuta Abe and Takeshi Aoki and Horacio J. Asbun and Albert C. Y. Chan and Rawisak Chanwat and Kuo-Hsin Chen and Yajin Chen and Tan To Cheung and David Fuks and Naoto Gotohda and Ho-Seong Han and Kiyoshi Hasegawa and Etsuro Hatano and Goro Honda and Osamu Itano and Yukio Iwashita and Hironori Kaneko and Yutaro Kato and Ji Hoon Kim and Rong Liu and Santiago López-Ben and Mamoru Morimoto and Kazuteru Monden and Fernando Rotellar and Yoshihiro Sakamoto and Atsushi Sugioka and Tomoharu Yoshiizumi and Keiichi Akahoshi and Felipe Alconchel and Shunichi Ariizumi and Andrea Benedetti Cacciaguerra and Manuel Durán and Alain Garcia Vazquez and Nicolas Golse and Yoshihiro Miyasaka and Yasuhisa Mori and Satoshi Ogiso and Chikara Shirata and Federico Tomassini and Takeshi Urade and Taiga Wakabayashi and Hitoe Nishino and Taizo Hibi and Norihiro Kokudo and Masayuki Ohtsuka and Daisuke Ban and Yuichi Nagakawa and Takao Ohtsuka and Minoru Tanabe and Masafumi Nakamura and Akihiko Tsuchida and Masakazu Yamamoto},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85123901612&doi=10.1002%2fjhbp.1091&partnerID=40&md5=6f9e9231b8cbd8b84b02db4d4c118e4c},
doi = {10.1002/jhbp.1091},
issn = {18686974},
year = {2022},
date = {2022-01-01},
urldate = {2022-01-01},
journal = {Journal of Hepato-Biliary-Pancreatic Sciences},
volume = {29},
number = {1},
pages = {6 – 15},
publisher = {John Wiley and Sons Inc},
abstract = {Background: The Brisbane 2000 Terminology for Liver Anatomy and Resections, based on Couinaud’s segments, did not address how to identify segmental borders and anatomic territories of less than one segment. Smaller anatomic resections including segmentectomies and subsegmentectomies, have not been well defined. The advent of minimally invasive liver resection has enhanced the possibilities of more precise resection due to a magnified view and reduced bleeding, and minimally invasive anatomic liver resection (MIALR) is becoming popular gradually. Therefore, there is a need for updating the Brisbane 2000 system, including anatomic segmentectomy or less. An online "Expert Consensus Meeting: Precision Anatomy for Minimally Invasive HBP Surgery (PAM-HBP Surgery Consensus)" was hosted on February 23, 2021. Methods: The Steering Committee invited 34 international experts from around the world. The Expert Committee (EC) selected 12 questions and two future research topics in the terminology session. The EC created seven tentative definitions and five recommendations based on the experts’ opinions and the literature review performed by the Research Committee. Two Delphi Rounds finalized those definitions and recommendations. Results: This paper presents seven definitions and five recommendations regarding anatomic segmentectomy or less. In addition, two future research topics are discussed. Conclusions: The PAM-HBP Surgery Consensus has presented the Tokyo 2020 Terminology for Liver Anatomy and Resections. The terminology has added definitions of liver anatomy and resections that were not defined in the Brisbane 2000 system. © 2021 Japanese Society of Hepato-Biliary-Pancreatic Surgery},
note = {Cited by: 6},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Background: The Brisbane 2000 Terminology for Liver Anatomy and Resections, based on Couinaud’s segments, did not address how to identify segmental borders and anatomic territories of less than one segment. Smaller anatomic resections including segmentectomies and subsegmentectomies, have not been well defined. The advent of minimally invasive liver resection has enhanced the possibilities of more precise resection due to a magnified view and reduced bleeding, and minimally invasive anatomic liver resection (MIALR) is becoming popular gradually. Therefore, there is a need for updating the Brisbane 2000 system, including anatomic segmentectomy or less. An online "Expert Consensus Meeting: Precision Anatomy for Minimally Invasive HBP Surgery (PAM-HBP Surgery Consensus)" was hosted on February 23, 2021. Methods: The Steering Committee invited 34 international experts from around the world. The Expert Committee (EC) selected 12 questions and two future research topics in the terminology session. The EC created seven tentative definitions and five recommendations based on the experts’ opinions and the literature review performed by the Research Committee. Two Delphi Rounds finalized those definitions and recommendations. Results: This paper presents seven definitions and five recommendations regarding anatomic segmentectomy or less. In addition, two future research topics are discussed. Conclusions: The PAM-HBP Surgery Consensus has presented the Tokyo 2020 Terminology for Liver Anatomy and Resections. The terminology has added definitions of liver anatomy and resections that were not defined in the Brisbane 2000 system. © 2021 Japanese Society of Hepato-Biliary-Pancreatic Surgery
2021
Nagino M; DeMatteo R; Lang H; Cherqui D; Malago M; Kawakatsu S; DeOliveira M L; Adam R; Aldrighetti L; Boudjema K; Chapman W; Clary B; Santibañes E; Dong J; Ebata T; Endo I; Geller D; Guglielmi A; Kato T; Lee S; Lodge P; Nadalin S; Pinna A; Polak W; Soubrane O; Clavien P
Proposal of a New Comprehensive Notation for Hepatectomy: The “New World” Terminology. Journal Article
In: Annals of surgery, vol. 274, no 1, pp. 1 – 3, 2021, ISSN: 15281140, (Cited by: 19).
@article{Nagino20211,
title = {Proposal of a New Comprehensive Notation for Hepatectomy: The “New World” Terminology.},
author = {Masato Nagino and Ronald DeMatteo and Hauke Lang and Daniel Cherqui and Massimo Malago and Shoji Kawakatsu and Michelle L. DeOliveira and René Adam and Luca Aldrighetti and Karim Boudjema and William Chapman and Bryan Clary and Eduardo Santibañes and Jiahong Dong and Tomoki Ebata and Itaru Endo and David Geller and Alfredo Guglielmi and Tomoaki Kato and Sung-Gyu Lee and Peter Lodge and Silvio Nadalin and Antonio Pinna and Wojciech Polak and Olivier Soubrane and Pierre-Alain Clavien},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85108024104&doi=10.1097%2fSLA.0000000000004808&partnerID=40&md5=9da2460f0c3f3e0fe36fd600e7032d8d},
doi = {10.1097/SLA.0000000000004808},
issn = {15281140},
year = {2021},
date = {2021-01-01},
urldate = {2021-01-01},
journal = {Annals of surgery},
volume = {274},
number = {1},
pages = {1 – 3},
publisher = {NLM (Medline)},
note = {Cited by: 19},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Wang X; Teh C S C; Ishizawa T; Aoki T; Cavallucci D; Lee S; Panganiban K M; Perini M V; Shah S R; Wang H; Xu Y; Suh K; Kokudo N
Consensus Guidelines for the Use of Fluorescence Imaging in Hepatobiliary Surgery Journal Article
In: Annals of surgery, vol. 274, no 1, pp. 97 – 106, 2021, ISSN: 15281140, (Cited by: 30).
@article{Wang202197,
title = {Consensus Guidelines for the Use of Fluorescence Imaging in Hepatobiliary Surgery},
author = {Xiaoying Wang and Catherine S C Teh and Takeaki Ishizawa and Takeshi Aoki and David Cavallucci and Ser-Yee Lee and Katherine M. Panganiban and Marcos V. Perini and Sudeep R. Shah and Hongguang Wang and Yinzhe Xu and Kyung-Suk Suh and Norihiro Kokudo},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85105385798&doi=10.1097%2fSLA.0000000000004718&partnerID=40&md5=a88db25d451b046b430edd839c2dc3ee},
doi = {10.1097/SLA.0000000000004718},
issn = {15281140},
year = {2021},
date = {2021-01-01},
urldate = {2021-01-01},
journal = {Annals of surgery},
volume = {274},
number = {1},
pages = {97 – 106},
publisher = {NLM (Medline)},
abstract = {OBJECTIVE: To establish consensus recommendations for the use of fluorescence imaging with indocyanine green (ICG) in hepatobiliary surgery. BACKGROUND: ICG fluorescence imaging has gained popularity in hepatobiliary surgery in recent years. However, there is varied evidence on the use, dosage, and timing of administration of ICG in clinical practice. To standardize the use of this imaging modality in hepatobiliary surgery, a panel of pioneering experts from the Asia-Pacific region sought to establish a set of consensus recommendations by consolidating the available evidence and clinical experiences. METHODS: A total of 13 surgeons experienced in hepatobiliary surgery and/or minimally invasive surgery formed an expert consensus panel in Shanghai, China in October 2018. By the modified Delphi method, they presented the relevant evidence, discussed clinical experiences, and derived consensus statements on the use of ICG in hepatobiliary surgery. Each statement was discussed and modified until a unanimous consensus was achieved. RESULTS: A total of 7 recommendations for the clinical applications of ICG in hepatobiliary surgery were formulated. CONCLUSIONS: The Shanghai consensus recommendations offer practical tips and techniques to augment the safety and technical feasibility of ICG fluorescence-guided hepatobiliary surgery, including laparoscopic cholecystectomy, liver segmentectomy, and liver transplantation. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.},
note = {Cited by: 30},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: To establish consensus recommendations for the use of fluorescence imaging with indocyanine green (ICG) in hepatobiliary surgery. BACKGROUND: ICG fluorescence imaging has gained popularity in hepatobiliary surgery in recent years. However, there is varied evidence on the use, dosage, and timing of administration of ICG in clinical practice. To standardize the use of this imaging modality in hepatobiliary surgery, a panel of pioneering experts from the Asia-Pacific region sought to establish a set of consensus recommendations by consolidating the available evidence and clinical experiences. METHODS: A total of 13 surgeons experienced in hepatobiliary surgery and/or minimally invasive surgery formed an expert consensus panel in Shanghai, China in October 2018. By the modified Delphi method, they presented the relevant evidence, discussed clinical experiences, and derived consensus statements on the use of ICG in hepatobiliary surgery. Each statement was discussed and modified until a unanimous consensus was achieved. RESULTS: A total of 7 recommendations for the clinical applications of ICG in hepatobiliary surgery were formulated. CONCLUSIONS: The Shanghai consensus recommendations offer practical tips and techniques to augment the safety and technical feasibility of ICG fluorescence-guided hepatobiliary surgery, including laparoscopic cholecystectomy, liver segmentectomy, and liver transplantation. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.
2020
Franchi E; Donadon M; Torzilli G
Effects of volume on outcome in hepatobiliary surgery: a review with guidelines proposal Journal Article
In: Glob Health Med, vol. 2, no 5, pp. 292–297, 2020, ISSN: 2434-9194.
@article{pmid33330823,
title = {Effects of volume on outcome in hepatobiliary surgery: a review with guidelines proposal},
author = {Eloisa Franchi and Matteo Donadon and Guido Torzilli},
doi = {10.35772/ghm.2020.01013},
issn = {2434-9194},
year = {2020},
date = {2020-10-01},
urldate = {2020-10-01},
journal = {Glob Health Med},
volume = {2},
number = {5},
pages = {292--297},
abstract = {The positive relationship between volume and outcome in hepatobiliary surgery has been demonstrated for many years. As for other complex surgical procedures, both improved short- and long-term outcomes have been associated with a higher volume of procedures. However, whether the centralization of complex hepatobiliary procedures makes full sense because it should be associated with higher quality of care, as reported in the literature, precise criteria on what to centralize, where to centralize, and who should be entitled to perform complex procedures are still missing. Indeed, despite the generalized consensus on centralization in hepatobiliary surgery, this topic remains very complex because many determinants are involved in such a centralization process, of which some of them cannot be easily controlled. In the context of different health systems worldwide, such as national health systems and private insurance, there are different stakeholders that demand different needs: politicians, patients, surgeons, institutions and medical associations do not always have the same needs. Starting from a review of the literature on centralization in hepatobiliary surgery, we will propose some guidelines that, while not data-driven due to low evidence in the literature, will be based on good clinical practice.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The positive relationship between volume and outcome in hepatobiliary surgery has been demonstrated for many years. As for other complex surgical procedures, both improved short- and long-term outcomes have been associated with a higher volume of procedures. However, whether the centralization of complex hepatobiliary procedures makes full sense because it should be associated with higher quality of care, as reported in the literature, precise criteria on what to centralize, where to centralize, and who should be entitled to perform complex procedures are still missing. Indeed, despite the generalized consensus on centralization in hepatobiliary surgery, this topic remains very complex because many determinants are involved in such a centralization process, of which some of them cannot be easily controlled. In the context of different health systems worldwide, such as national health systems and private insurance, there are different stakeholders that demand different needs: politicians, patients, surgeons, institutions and medical associations do not always have the same needs. Starting from a review of the literature on centralization in hepatobiliary surgery, we will propose some guidelines that, while not data-driven due to low evidence in the literature, will be based on good clinical practice.
Fang C; An J; Bruno A; Cai X; Fan J; Fujimoto J; Golfieri R; Hao X; Jiang H; Jiao L R; Kulkarni A V; Lang H; Lesmana C R A; Li Q; Liu L; Liu Y; Lau W; Lu Q; Man K; Maruyama H; Mosconi C; Örmeci N; Pavlides M; Rezende G; Sohn J H; Treeprasertsuk S; Vilgrain V; Wen H; Wen S; Quan X; Ximenes R; Yang Y; Zhang B; Zhang W; Zhang P; Zhang S; Qi X
Consensus recommendations of three-dimensional visualization for diagnosis and management of liver diseases Journal Article
In: Hepatology International, vol. 14, no 4, pp. 437 – 453, 2020, ISSN: 19360533, (Cited by: 31; All Open Access, Green Open Access, Hybrid Gold Open Access).
@article{Fang2020437,
title = {Consensus recommendations of three-dimensional visualization for diagnosis and management of liver diseases},
author = {Chihua Fang and Jihyun An and Antonio Bruno and Xiujun Cai and Jia Fan and Jiro Fujimoto and Rita Golfieri and Xishan Hao and Hongchi Jiang and Long R. Jiao and Anand V. Kulkarni and Hauke Lang and Cosmas Rinaldi A. Lesmana and Qiang Li and Lianxin Liu and Yingbin Liu and Wanyee Lau and Qiping Lu and Kwan Man and Hitoshi Maruyama and Cristina Mosconi and Necati Örmeci and Michael Pavlides and Guilherme Rezende and Joo Hyun Sohn and Sombat Treeprasertsuk and Valérie Vilgrain and Hao Wen and Sai Wen and Xianyao Quan and Rafael Ximenes and Yinmo Yang and Bixiang Zhang and Weiqi Zhang and Peng Zhang and Shaoxiang Zhang and Xiaolong Qi},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85087609785&doi=10.1007%2fs12072-020-10052-y&partnerID=40&md5=bcbb629f80465ca27b81b8112b76e9a8},
doi = {10.1007/s12072-020-10052-y},
issn = {19360533},
year = {2020},
date = {2020-01-01},
urldate = {2020-01-01},
journal = {Hepatology International},
volume = {14},
number = {4},
pages = {437 – 453},
publisher = {Springer},
abstract = {Three-dimensional (3D) visualization involves feature extraction and 3D reconstruction of CT images using a computer processing technology. It is a tool for displaying, describing, and interpreting 3D anatomy and morphological features of organs, thus providing intuitive, stereoscopic, and accurate methods for clinical decision-making. It has played an increasingly significant role in the diagnosis and management of liver diseases. Over the last decade, it has been proven safe and effective to use 3D simulation software for pre-hepatectomy assessment, virtual hepatectomy, and measurement of liver volumes in blood flow areas of the portal vein; meanwhile, the use of 3D models in combination with hydrodynamic analysis has become a novel non-invasive method for diagnosis and detection of portal hypertension. We herein describe the progress of research on 3D visualization, its workflow, current situation, challenges, opportunities, and its capacity to improve clinical decision-making, emphasizing its utility for patients with liver diseases. Current advances in modern imaging technologies have promised a further increase in diagnostic efficacy of liver diseases. For example, complex internal anatomy of the liver and detailed morphological features of liver lesions can be reflected from CT-based 3D models. A meta-analysis reported that the application of 3D visualization technology in the diagnosis and management of primary hepatocellular carcinoma has significant or extremely significant differences over the control group in terms of intraoperative blood loss, postoperative complications, recovery of postoperative liver function, operation time, hospitalization time, and tumor recurrence on short-term follow-up. However, the acquisition of high-quality CT images and the use of these images for 3D visualization processing lack a unified standard, quality control system, and homogeneity, which might hinder the evaluation of application efficacy in different clinical centers, causing enormous inconvenience to clinical practice and scientific research. Therefore, rigorous operating guidelines and quality control systems need to be established for 3D visualization of liver to develop it to become a mature technology. Herein, we provide recommendations for the research on diagnosis and management of 3D visualization in liver diseases to meet this urgent need in this research field. © 2020, The Author(s).},
note = {Cited by: 31; All Open Access, Green Open Access, Hybrid Gold Open Access},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Three-dimensional (3D) visualization involves feature extraction and 3D reconstruction of CT images using a computer processing technology. It is a tool for displaying, describing, and interpreting 3D anatomy and morphological features of organs, thus providing intuitive, stereoscopic, and accurate methods for clinical decision-making. It has played an increasingly significant role in the diagnosis and management of liver diseases. Over the last decade, it has been proven safe and effective to use 3D simulation software for pre-hepatectomy assessment, virtual hepatectomy, and measurement of liver volumes in blood flow areas of the portal vein; meanwhile, the use of 3D models in combination with hydrodynamic analysis has become a novel non-invasive method for diagnosis and detection of portal hypertension. We herein describe the progress of research on 3D visualization, its workflow, current situation, challenges, opportunities, and its capacity to improve clinical decision-making, emphasizing its utility for patients with liver diseases. Current advances in modern imaging technologies have promised a further increase in diagnostic efficacy of liver diseases. For example, complex internal anatomy of the liver and detailed morphological features of liver lesions can be reflected from CT-based 3D models. A meta-analysis reported that the application of 3D visualization technology in the diagnosis and management of primary hepatocellular carcinoma has significant or extremely significant differences over the control group in terms of intraoperative blood loss, postoperative complications, recovery of postoperative liver function, operation time, hospitalization time, and tumor recurrence on short-term follow-up. However, the acquisition of high-quality CT images and the use of these images for 3D visualization processing lack a unified standard, quality control system, and homogeneity, which might hinder the evaluation of application efficacy in different clinical centers, causing enormous inconvenience to clinical practice and scientific research. Therefore, rigorous operating guidelines and quality control systems need to be established for 3D visualization of liver to develop it to become a mature technology. Herein, we provide recommendations for the research on diagnosis and management of 3D visualization in liver diseases to meet this urgent need in this research field. © 2020, The Author(s).
2016
Oldhafer K J; Stavrou G A; Gulik T M V; Santibanes E D; Malago M; Schadde E; Hernandez-Alejandro R; Kokudo N; Aloia T A; Abdalla E; Linecker M; Clavien P
ALPPS - Where do we stand, where do we go? Eight recommendations from the first international expert meeting Journal Article
In: Annals of Surgery, vol. 263, no 5, pp. 839 – 841, 2016, ISSN: 00034932, (Cited by: 72).
@article{Oldhafer2016839,
title = {ALPPS - Where do we stand, where do we go? Eight recommendations from the first international expert meeting},
author = {Karl J. Oldhafer and Gregor A. Stavrou and Thomas M. Van Gulik and Eduardo De Santibanes and Massimo Malago and Erik Schadde and Roberto Hernandez-Alejandro and Norihiro Kokudo and Thomas A. Aloia and Eddie Abdalla and Michael Linecker and Pierre-Alain Clavien},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84954349162&doi=10.1097%2fSLA.0000000000001633&partnerID=40&md5=ca8561df7687e0cbca254010764f2404},
doi = {10.1097/SLA.0000000000001633},
issn = {00034932},
year = {2016},
date = {2016-01-01},
urldate = {2016-01-01},
journal = {Annals of Surgery},
volume = {263},
number = {5},
pages = {839 – 841},
publisher = {Lippincott Williams and Wilkins},
note = {Cited by: 72},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2013
Bismuth H
Revisiting liver anatomy and terminology of hepatectomies Journal Article
In: Annals of Surgery, vol. 257, no 3, pp. 383 – 386, 2013, ISSN: 15281140, (Cited by: 63).
@article{Bismuth2013383,
title = {Revisiting liver anatomy and terminology of hepatectomies},
author = {Henri Bismuth},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84873910931&doi=10.1097%2fSLA.0b013e31827f171f&partnerID=40&md5=ff485d490eb33b4bbf7bbf71e1cf8494},
doi = {10.1097/SLA.0b013e31827f171f},
issn = {15281140},
year = {2013},
date = {2013-01-01},
urldate = {2013-01-01},
journal = {Annals of Surgery},
volume = {257},
number = {3},
pages = {383 – 386},
abstract = {Background:: Since the development of liver surgery, several descriptions of liver anatomical division and hepatectomies have been made, causing some confusion among surgeons. METHODS:: The initial anatomical description according to Couinaud is reviewed and corrected taking into account the descriptions made in the following decades. RESULTS:: It seems that by reviewing the description of the different authors, a precise anatomical division of the liver may be achieved and a simple terminology of hepatectomies may be proposed. CONCLUSIONS:: It is hoped that the proposal of this anatomical description and this terminology of hepatectomies may find a consensus among the liver surgical community from America, Asia, and Europe. © 2013 by Lippincott Williams & Wilkins.},
note = {Cited by: 63},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Background:: Since the development of liver surgery, several descriptions of liver anatomical division and hepatectomies have been made, causing some confusion among surgeons. METHODS:: The initial anatomical description according to Couinaud is reviewed and corrected taking into account the descriptions made in the following decades. RESULTS:: It seems that by reviewing the description of the different authors, a precise anatomical division of the liver may be achieved and a simple terminology of hepatectomies may be proposed. CONCLUSIONS:: It is hoped that the proposal of this anatomical description and this terminology of hepatectomies may find a consensus among the liver surgical community from America, Asia, and Europe. © 2013 by Lippincott Williams & Wilkins.
2011
Koch M; Garden O J; Padbury R; Rahbari N N; Adam R; Capussotti L; Fan S T; Yokoyama Y; Crawford M; Makuuchi M; Christophi C; Banting S; Brooke-Smith M; Usatoff V; Nagino M; Maddern G; Hugh T J; Vauthey J; Greig P; Rees M; Nimura Y; Figueras J; Dematteo R P; Büchler M W; Weitz J
Bile leakage after hepatobiliary and pancreatic surgery: A definition and grading of severity by the International Study Group of Liver Surgery Journal Article
In: Surgery, vol. 149, no 5, pp. 680 – 688, 2011, ISSN: 00396060, (Cited by: 922).
@article{Koch2011680,
title = {Bile leakage after hepatobiliary and pancreatic surgery: A definition and grading of severity by the International Study Group of Liver Surgery},
author = {Moritz Koch and O. James Garden and Robert Padbury and Nuh N. Rahbari and Rene Adam and Lorenzo Capussotti and Sheung Tat Fan and Yukihiro Yokoyama and Michael Crawford and Masatoshi Makuuchi and Christopher Christophi and Simon Banting and Mark Brooke-Smith and Val Usatoff and Masato Nagino and Guy Maddern and Thomas J. Hugh and Jean-Nicolas Vauthey and Paul Greig and Myrddin Rees and Yuji Nimura and Joan Figueras and Ronald P. Dematteo and Markus W. Büchler and Jürgen Weitz},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-79954631448&doi=10.1016%2fj.surg.2010.12.002&partnerID=40&md5=03a3984fc9b28e491c0fc8aea01a094a},
doi = {10.1016/j.surg.2010.12.002},
issn = {00396060},
year = {2011},
date = {2011-01-01},
urldate = {2011-01-01},
journal = {Surgery},
volume = {149},
number = {5},
pages = {680 – 688},
abstract = {Background: Despite the potentially severe impact of bile leakage on patients' perioperative and long-term outcome, a commonly used definition of this complication after hepatobiliary and pancreatic operations has not yet been established. The aim of the present article is to propose a uniform definition and severity grading of bile leakage after hepatobiliary and pancreatic operative therapy. Methods: An international study group of hepatobiliary and pancreatic surgeons was convened. A consensus definition of bile leakage after hepatobiliary and pancreatic operative therapy was developed based on the postoperative course of bilirubin concentrations in patients' serum and drain fluid. Results: After evaluation of the postoperative course of bilirubin levels in the drain fluid of patients who underwent hepatobiliary and pancreatic operations, bile leakage was defined as bilirubin concentration in the drain fluid at least 3 times the serum bilirubin concentration on or after postoperative day 3 or as the need for radiologic or operative intervention resulting from biliary collections or bile peritonitis. Using this criterion severity of bile leakage was classified according to its impact on patients' clinical management. Grade A bile leakage causes no change in patients' clinical management. A Grade B bile leakage requires active therapeutic intervention but is manageable without relaparotomy, whereas in Grade C, bile leakage relaparotomy is required. Conclusion: We propose a simple definition and severity grading of bile leakage after hepatobiliary and pancreatic operative therapy. The application of the present proposal will enable a standardized comparison of the results of different clinical trials and may facilitate an objective evaluation of diagnostic and therapeutic modalities in the field of hepatobiliary and pancreatic operative therapy. © 2011 Mosby, Inc.},
note = {Cited by: 922},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Background: Despite the potentially severe impact of bile leakage on patients' perioperative and long-term outcome, a commonly used definition of this complication after hepatobiliary and pancreatic operations has not yet been established. The aim of the present article is to propose a uniform definition and severity grading of bile leakage after hepatobiliary and pancreatic operative therapy. Methods: An international study group of hepatobiliary and pancreatic surgeons was convened. A consensus definition of bile leakage after hepatobiliary and pancreatic operative therapy was developed based on the postoperative course of bilirubin concentrations in patients' serum and drain fluid. Results: After evaluation of the postoperative course of bilirubin levels in the drain fluid of patients who underwent hepatobiliary and pancreatic operations, bile leakage was defined as bilirubin concentration in the drain fluid at least 3 times the serum bilirubin concentration on or after postoperative day 3 or as the need for radiologic or operative intervention resulting from biliary collections or bile peritonitis. Using this criterion severity of bile leakage was classified according to its impact on patients' clinical management. Grade A bile leakage causes no change in patients' clinical management. A Grade B bile leakage requires active therapeutic intervention but is manageable without relaparotomy, whereas in Grade C, bile leakage relaparotomy is required. Conclusion: We propose a simple definition and severity grading of bile leakage after hepatobiliary and pancreatic operative therapy. The application of the present proposal will enable a standardized comparison of the results of different clinical trials and may facilitate an objective evaluation of diagnostic and therapeutic modalities in the field of hepatobiliary and pancreatic operative therapy. © 2011 Mosby, Inc.
Rahbari N N; Garden O J; Padbury R; Brooke-Smith M; Crawford M; Adam R; Koch M; Makuuchi M; Dematteo R P; Christophi C; Banting S; Usatoff V; Nagino M; Maddern G; Hugh T J; Vauthey J; Greig P; Rees M; Yokoyama Y; Fan S T; Nimura Y; Figueras J; Capussotti L; Büchler M W; Weitz J
Posthepatectomy liver failure: A definition and grading by the International Study Group of Liver Surgery (ISGLS) Journal Article
In: Surgery, vol. 149, no 5, pp. 713 – 724, 2011, ISSN: 00396060, (Cited by: 1234).
@article{Rahbari2011713b,
title = {Posthepatectomy liver failure: A definition and grading by the International Study Group of Liver Surgery (ISGLS)},
author = {Nuh N. Rahbari and O. James Garden and Robert Padbury and Mark Brooke-Smith and Michael Crawford and Rene Adam and Moritz Koch and Masatoshi Makuuchi and Ronald P. Dematteo and Christopher Christophi and Simon Banting and Val Usatoff and Masato Nagino and Guy Maddern and Thomas J. Hugh and Jean-Nicolas Vauthey and Paul Greig and Myrddin Rees and Yukihiro Yokoyama and Sheung Tat Fan and Yuji Nimura and Joan Figueras and Lorenzo Capussotti and Markus W. Büchler and Jürgen Weitz},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-79954634037&doi=10.1016%2fj.surg.2010.10.001&partnerID=40&md5=ee2737ef3993a9fda5725bfeff03d385},
doi = {10.1016/j.surg.2010.10.001},
issn = {00396060},
year = {2011},
date = {2011-01-01},
urldate = {2011-01-01},
journal = {Surgery},
volume = {149},
number = {5},
pages = {713 – 724},
abstract = {Background: Posthepatectomy liver failure is a feared complication after hepatic resection and a major cause of perioperative mortality. There is currently no standardized definition of posthepatectomy liver failure that allows valid comparison of results from different studies and institutions. The aim of the current article was to propose a definition and grading of severity of posthepatectomy liver failure. Methods: A literature search on posthepatectomy liver failure after hepatic resection was conducted. Based on the normal course of biochemical liver function tests after hepatic resection, a simple and easily applicable definition of posthepatectomy liver failure was developed by the International Study Group of Liver Surgery. Furthermore, a grading of severity is proposed based on the impact on patients' clinical management. Results: No uniform definition of posthepatectomy liver failure has been established in the literature addressing hepatic surgery. Considering the normal postoperative course of serum bilirubin concentration and International Normalized Ratio, we propose defining posthepatectomy liver failure as the impaired ability of the liver to maintain its synthetic, excretory, and detoxifying functions, which are characterized by an increased international normalized ratio and concomitant hyperbilirubinemia (according to the normal limits of the local laboratory) on or after postoperative day 5. The severity of posthepatectomy liver failure should be graded based on its impact on clinical management. Grade A posthepatectomy liver failure requires no change of the patient's clinical management. The clinical management of patients with grade B posthepatectomy liver failure deviates from the regular course but does not require invasive therapy. The need for invasive treatment defines grade C posthepatectomy liver failure. Conclusion: The current definition of posthepatectomy liver failure is simple and easily applicable in clinical routine. This definition can be used in future studies to allow objective and accurate comparisons of operative interventions in the field of hepatic surgery. © 2011 Mosby, Inc.},
note = {Cited by: 1234},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Background: Posthepatectomy liver failure is a feared complication after hepatic resection and a major cause of perioperative mortality. There is currently no standardized definition of posthepatectomy liver failure that allows valid comparison of results from different studies and institutions. The aim of the current article was to propose a definition and grading of severity of posthepatectomy liver failure. Methods: A literature search on posthepatectomy liver failure after hepatic resection was conducted. Based on the normal course of biochemical liver function tests after hepatic resection, a simple and easily applicable definition of posthepatectomy liver failure was developed by the International Study Group of Liver Surgery. Furthermore, a grading of severity is proposed based on the impact on patients' clinical management. Results: No uniform definition of posthepatectomy liver failure has been established in the literature addressing hepatic surgery. Considering the normal postoperative course of serum bilirubin concentration and International Normalized Ratio, we propose defining posthepatectomy liver failure as the impaired ability of the liver to maintain its synthetic, excretory, and detoxifying functions, which are characterized by an increased international normalized ratio and concomitant hyperbilirubinemia (according to the normal limits of the local laboratory) on or after postoperative day 5. The severity of posthepatectomy liver failure should be graded based on its impact on clinical management. Grade A posthepatectomy liver failure requires no change of the patient's clinical management. The clinical management of patients with grade B posthepatectomy liver failure deviates from the regular course but does not require invasive therapy. The need for invasive treatment defines grade C posthepatectomy liver failure. Conclusion: The current definition of posthepatectomy liver failure is simple and easily applicable in clinical routine. This definition can be used in future studies to allow objective and accurate comparisons of operative interventions in the field of hepatic surgery. © 2011 Mosby, Inc.
Rahbari N N; Garden O J; Padbury R; Maddern G; Koch M; Hugh T J; Fan S T; Nimura Y; Figueras J; Vauthey J; Rees M; Adam R; Dematteo R P; Greig P; Usatoff V; Banting S; Nagino M; Capussotti L; Yokoyama Y; Brooke-Smith M; Crawford M; Christophi C; Makuuchi M; Büchler M W; Weitz J
Post-hepatectomy haemorrhage: A definition and grading by the International Study Group of Liver Surgery (ISGLS) Journal Article
In: HPB, vol. 13, no 8, pp. 528 – 535, 2011, ISSN: 1365182X, (Cited by: 212; All Open Access, Bronze Open Access, Green Open Access).
@article{Rahbari2011528,
title = {Post-hepatectomy haemorrhage: A definition and grading by the International Study Group of Liver Surgery (ISGLS)},
author = {Nuh N. Rahbari and O. James Garden and Robert Padbury and Guy Maddern and Moritz Koch and Thomas J. Hugh and Sheung Tat Fan and Yuji Nimura and Joan Figueras and Jean-Nicolas Vauthey and Myrddin Rees and Rene Adam and Ronald P. Dematteo and Paul Greig and Val Usatoff and Simon Banting and Masato Nagino and Lorenzo Capussotti and Yukihiro Yokoyama and Mark Brooke-Smith and Michael Crawford and Christopher Christophi and Masatoshi Makuuchi and Markus W. Büchler and Jürgen Weitz},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-79960563603&doi=10.1111%2fj.1477-2574.2011.00319.x&partnerID=40&md5=192d9ea9c6b2cd47f539e1383e6e191d},
doi = {10.1111/j.1477-2574.2011.00319.x},
issn = {1365182X},
year = {2011},
date = {2011-01-01},
urldate = {2011-01-01},
journal = {HPB},
volume = {13},
number = {8},
pages = {528 – 535},
publisher = {Blackwell Publishing Ltd},
abstract = {Background: A standardized definition of post-hepatectomy haemorrhage (PHH) has not yet been established. Methods: An international study group of hepatobiliary surgeons from high-volume centres was convened and a definition of PHH was developed together with a grading of severity considering the impact on patients' clinical management. Results: The definition of PHH varies strongly within the hepatic surgery literature. PHH is defined as a drop in haemoglobin level >3 g/dl post-operatively compared with the post-operative baseline level and/or any post-operative transfusion of packed red blood cells (PRBC) for a falling haemoglobin and/or the need for radiological intervention (such as embolization) and/or re-laparotomy to stop bleeding. Evidence of intra-abdominal bleeding should be obtained by imaging or blood loss via the abdominal drains if present. Transfusion of up to two units of PRBC is considered as being Grade A PHH. Grade B PHH requires transfusion of more than two units of PRBC, whereas the need for invasive re-intervention such as embolization and/ or re-laparotomy defines Grade C PHH. Conclusion: The proposed definition and grading of severity of PHH enables valid comparisons of results from different studies. It is easily applicable in clinical routine and should be applied in future trials to standardize reporting of complications. © 2011 International Hepato-Pancreato-Biliary Association.},
note = {Cited by: 212; All Open Access, Bronze Open Access, Green Open Access},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Background: A standardized definition of post-hepatectomy haemorrhage (PHH) has not yet been established. Methods: An international study group of hepatobiliary surgeons from high-volume centres was convened and a definition of PHH was developed together with a grading of severity considering the impact on patients' clinical management. Results: The definition of PHH varies strongly within the hepatic surgery literature. PHH is defined as a drop in haemoglobin level >3 g/dl post-operatively compared with the post-operative baseline level and/or any post-operative transfusion of packed red blood cells (PRBC) for a falling haemoglobin and/or the need for radiological intervention (such as embolization) and/or re-laparotomy to stop bleeding. Evidence of intra-abdominal bleeding should be obtained by imaging or blood loss via the abdominal drains if present. Transfusion of up to two units of PRBC is considered as being Grade A PHH. Grade B PHH requires transfusion of more than two units of PRBC, whereas the need for invasive re-intervention such as embolization and/ or re-laparotomy defines Grade C PHH. Conclusion: The proposed definition and grading of severity of PHH enables valid comparisons of results from different studies. It is easily applicable in clinical routine and should be applied in future trials to standardize reporting of complications. © 2011 International Hepato-Pancreato-Biliary Association.
2005
Strasberg S M
Nomenclature of hepatic anatomy and resections: A review of the Brisbane 2000 system Journal Article
In: Journal of Hepato-Biliary-Pancreatic Surgery, vol. 12, no 5, pp. 351 – 355, 2005, ISSN: 09441166, (Cited by: 598).
@article{Strasberg2005351,
title = {Nomenclature of hepatic anatomy and resections: A review of the Brisbane 2000 system},
author = {Steven M. Strasberg},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-27944465366&doi=10.1007%2fs00534-005-0999-7&partnerID=40&md5=40e30476f1199aa456d45f17063fe258},
doi = {10.1007/s00534-005-0999-7},
issn = {09441166},
year = {2005},
date = {2005-01-01},
urldate = {2005-01-01},
journal = {Journal of Hepato-Biliary-Pancreatic Surgery},
volume = {12},
number = {5},
pages = {351 – 355},
abstract = {The Brisbane 2000 system of nomenclature of hepatic anatomy and resections was introduced to provide a universal terminology in an area that was plagued by confusing and inappropriate terminology. The article describes historical developments central to the emergence of the new terminology and describes the terminology, its attributes, and rules of application. © Springer-Verlag Tokyo 2005.},
note = {Cited by: 598},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The Brisbane 2000 system of nomenclature of hepatic anatomy and resections was introduced to provide a universal terminology in an area that was plagued by confusing and inappropriate terminology. The article describes historical developments central to the emergence of the new terminology and describes the terminology, its attributes, and rules of application. © Springer-Verlag Tokyo 2005.
2000
Strasberg S M; Belghiti J; Clavien P -A; Gadzijev E; Garden J O; Lau W -Y; Makuuchi M; Strong R W
The Brisbane 2000 Terminology of Liver Anatomy and Resections Journal Article
In: HPB, vol. 2, no 3, pp. 333-339, 2000, ISSN: 1365-182X.
@article{2000333,
title = {The Brisbane 2000 Terminology of Liver Anatomy and Resections},
author = {S. M. Strasberg and J. Belghiti and P. -A. Clavien and E. Gadzijev and J. O. Garden and W. -Y. Lau and M. Makuuchi and R. W. Strong},
url = {https://www.sciencedirect.com/science/article/pii/S1365182X17307554},
doi = {https://doi.org/10.1016/S1365-182X(17)30755-4},
issn = {1365-182X},
year = {2000},
date = {2000-01-01},
urldate = {2000-01-01},
journal = {HPB},
volume = {2},
number = {3},
pages = {333-339},
abstract = {Background
The Scientific Committee of the IHPBA, meeting in December 1998, created a Terminology Committee to deal with the confusion in nomenclature of hepatic anatomy and liver resections. A terminology was sought which was anatomically correct, in which anatomical and surgical terms agreed, and which was consistent, self-explanatory, linguistically correct, translatable, precise and concise.
Discussion
After 18 months the International Committee presented a terminology that was accepted by the IHPBA at the recent World Congress in Brisbane. The purpose of this paper is to present that terminology.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Background
The Scientific Committee of the IHPBA, meeting in December 1998, created a Terminology Committee to deal with the confusion in nomenclature of hepatic anatomy and liver resections. A terminology was sought which was anatomically correct, in which anatomical and surgical terms agreed, and which was consistent, self-explanatory, linguistically correct, translatable, precise and concise.
Discussion
After 18 months the International Committee presented a terminology that was accepted by the IHPBA at the recent World Congress in Brisbane. The purpose of this paper is to present that terminology.
The Scientific Committee of the IHPBA, meeting in December 1998, created a Terminology Committee to deal with the confusion in nomenclature of hepatic anatomy and liver resections. A terminology was sought which was anatomically correct, in which anatomical and surgical terms agreed, and which was consistent, self-explanatory, linguistically correct, translatable, precise and concise.
Discussion
After 18 months the International Committee presented a terminology that was accepted by the IHPBA at the recent World Congress in Brisbane. The purpose of this paper is to present that terminology.
1982
Bismuth H
Surgical anatomy and anatomical surgery of the liver Journal Article
In: World Journal of Surgery, vol. 6, no 1, pp. 3 – 9, 1982, ISSN: 14322323, (Cited by: 604).
@article{Bismuth19823,
title = {Surgical anatomy and anatomical surgery of the liver},
author = {Henri Bismuth},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-0020328518&doi=10.1007%2fBF01656368&partnerID=40&md5=a167ed853588202ea3a324c9838386e5},
doi = {10.1007/BF01656368},
issn = {14322323},
year = {1982},
date = {1982-01-01},
urldate = {1982-01-01},
journal = {World Journal of Surgery},
volume = {6},
number = {1},
pages = {3 – 9},
publisher = {Springer-Verlag},
abstract = {The morphologic anatomy of the liver is described as 2 main and 2 accessory lobes. The more recent functional anatomy of the liver is based on the distribution of the portal pedicles and the location of the hepatic veins. The liver is divided into 4 sectors, some of them composed of 2 segments. In all, there are 8 segments. According to the anatomy, typical hepatectomies (or "réglées") are those which are performed along anatomical scissurae. The 2 main technical conceptions of typical hepatectomies are those with preliminary vascular control (Lortat-Jacob's technique) and hepatectomies with primary parenchymatous transection (Ton That Tung's technique). A good knowledge of the anatomy of the liver is a prerequisite for anatomical surgery of this organ. © 1982 Société Internationale de Chirurgie.},
note = {Cited by: 604},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The morphologic anatomy of the liver is described as 2 main and 2 accessory lobes. The more recent functional anatomy of the liver is based on the distribution of the portal pedicles and the location of the hepatic veins. The liver is divided into 4 sectors, some of them composed of 2 segments. In all, there are 8 segments. According to the anatomy, typical hepatectomies (or "réglées") are those which are performed along anatomical scissurae. The 2 main technical conceptions of typical hepatectomies are those with preliminary vascular control (Lortat-Jacob's technique) and hepatectomies with primary parenchymatous transection (Ton That Tung's technique). A good knowledge of the anatomy of the liver is a prerequisite for anatomical surgery of this organ. © 1982 Société Internationale de Chirurgie.
Linee Guida per le Resezioni Epatiche Robotiche
2023
Liu R; Hilal M A; Wakabayashi G; Han H; Palanivelu C; Boggi U; Hackert T; Kim H; Wang X; Hu M; Choi G H; Panaro F; He J; Efanov M; Yin X; Croner R S; Fong Y; Zhu J; Wu Z; Sun C; Lee J H; Marino M V; Ganpati I S; Zhu P; Wang Z; Yang K; Fan J; Chen X; Lau W Y
International experts consensus guidelines on robotic liver resection in 2023 Journal Article
In: World Journal of Gastroenterology, vol. 29, no 32, pp. 4815 – 4830, 2023, ISSN: 10079327, (Cited by: 0; All Open Access, Hybrid Gold Open Access).
@article{Liu20234815,
title = {International experts consensus guidelines on robotic liver resection in 2023},
author = {Rong Liu and Mohammed Abu Hilal and Go Wakabayashi and Ho-Seong Han and Chinnusamy Palanivelu and Ugo Boggi and Thilo Hackert and Hong-Jin Kim and Xiao-Ying Wang and Ming-Gen Hu and Gi Hong Choi and Fabrizio Panaro and Jin He and Mikhail Efanov and Xiao-Yu Yin and Roland S. Croner and Yu-Man Fong and Ji-Ye Zhu and Zheng Wu and Chuan-Dong Sun and Jae Hoon Lee and Marco V. Marino and Iyer Shridhar Ganpati and Peng Zhu and Zi-Zheng Wang and Ke-Hu Yang and Jia Fan and Xiao-Ping Chen and Wan Yee Lau},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85170421518&doi=10.3748%2fwjg.v29.i32.4815&partnerID=40&md5=92dbb5eef5141f417941671602e6700a},
doi = {10.3748/wjg.v29.i32.4815},
issn = {10079327},
year = {2023},
date = {2023-01-01},
urldate = {2023-01-01},
journal = {World Journal of Gastroenterology},
volume = {29},
number = {32},
pages = {4815 – 4830},
publisher = {Baishideng Publishing Group Inc},
abstract = {The robotic liver resection (RLR) has been increasingly applied in recent years and its benefits shown in some aspects owing to the technical advancement of robotic surgical system, however, controversies still exist. Based on the foundation of the previous consensus statement, this new consensus document aimed to update clinical recommendations and provide guidance to improve the outcomes of RLR clinical practice. The guideline steering group and guideline expert group were formed by 29 international experts of liver surgery and evidence-based medicine (EBM). Relevant literature was reviewed and analyzed by the evidence evaluation group. According to the WHO Handbook for Guideline Development, the Guidance Principles of Development and Amendment of the Guidelines for Clinical Diagnosis and Treatment in China 2022, a total of 14 recommendations were generated. Among them were 8 recommendations formulated by the GRADE method, and the remaining 6 recommendations were formulated based on literature review and experts’ opinion due to insufficient EBM results. This international experts consensus guideline offered guidance for the safe and effective clinical practice and the research direction of RLR in future. ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.},
note = {Cited by: 0; All Open Access, Hybrid Gold Open Access},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The robotic liver resection (RLR) has been increasingly applied in recent years and its benefits shown in some aspects owing to the technical advancement of robotic surgical system, however, controversies still exist. Based on the foundation of the previous consensus statement, this new consensus document aimed to update clinical recommendations and provide guidance to improve the outcomes of RLR clinical practice. The guideline steering group and guideline expert group were formed by 29 international experts of liver surgery and evidence-based medicine (EBM). Relevant literature was reviewed and analyzed by the evidence evaluation group. According to the WHO Handbook for Guideline Development, the Guidance Principles of Development and Amendment of the Guidelines for Clinical Diagnosis and Treatment in China 2022, a total of 14 recommendations were generated. Among them were 8 recommendations formulated by the GRADE method, and the remaining 6 recommendations were formulated based on literature review and experts’ opinion due to insufficient EBM results. This international experts consensus guideline offered guidance for the safe and effective clinical practice and the research direction of RLR in future. ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
2019
Liu R; Wakabayashi G; Kim H; Choi G; Yiengpruksawan A; Fong Y; He J; Boggi U; Troisi R I; Efanov M; Azoulay D; Panaro F; Pessaux P; Wang X; Fan J; Zhu J; Zhang S; Sun C; Wu Z; Tao K; Yang K; Chen X
International consensus statement on robotic hepatectomy surgery in 2018 Journal Article
In: World Journal of Gastroenterology, vol. 25, no 12, pp. 1432 – 1444, 2019, ISSN: 10079327, (Cited by: 70; All Open Access, Green Open Access, Hybrid Gold Open Access).
@article{Liu20191432,
title = {International consensus statement on robotic hepatectomy surgery in 2018},
author = {Rong Liu and Go Wakabayashi and Hong-Jin Kim and Gi-Hong Choi and Anusak Yiengpruksawan and Yuman Fong and Jin He and Ugo Boggi and Roberto I. Troisi and Mikhail Efanov and Daniel Azoulay and Fabrizio Panaro and Patrick Pessaux and Xiao-Ying Wang and Jia Fan and Ji-Ye Zhu and Shao-Geng Zhang and Chuan-Dong Sun and Zheng Wu and Kai-Shan Tao and Ke-Hu Yang and Xiao-Ping Chen},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85063673983&doi=10.3748%2fwjg.v25.i12.1432&partnerID=40&md5=afeccf037878db987281db8a3aff459e},
doi = {10.3748/wjg.v25.i12.1432},
issn = {10079327},
year = {2019},
date = {2019-01-01},
urldate = {2019-01-01},
journal = {World Journal of Gastroenterology},
volume = {25},
number = {12},
pages = {1432 – 1444},
publisher = {Baishideng Publishing Group Co},
abstract = {The robotic surgical system has been applied in liver surgery. However, controversies concerns exist regarding a variety of factors including the safety, feasibility, efficacy, and cost-effectiveness of robotic surgery. To promote the development of robotic hepatectomy, this study aimed to evaluate the current status of robotic hepatectomy and provide sixty experts' consensus and recommendations to promote its development. Based on the World Health Organization Handbook for Guideline Development, a Consensus Steering Group and a Consensus Development Group were established to determine the topics, prepare evidence-based documents, and generate recommendations. The GRADE Grid method and Delphi vote were used to formulate the recommendations. A total of 22 topics were prepared analyzed and widely discussed during the 4 meetings. Based on the published articles and expert panel opinion, 7 recommendations were generated by the GRADE method using an evidence-based method, which focused on the safety, feasibility, indication, techniques and cost-effectiveness of hepatectomy. Given that the current evidences were low to very low as evaluated by the GRADE method, further randomized-controlled trials are needed in the future to validate these recommendations. © The Author(s) 2019.},
note = {Cited by: 70; All Open Access, Green Open Access, Hybrid Gold Open Access},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The robotic surgical system has been applied in liver surgery. However, controversies concerns exist regarding a variety of factors including the safety, feasibility, efficacy, and cost-effectiveness of robotic surgery. To promote the development of robotic hepatectomy, this study aimed to evaluate the current status of robotic hepatectomy and provide sixty experts' consensus and recommendations to promote its development. Based on the World Health Organization Handbook for Guideline Development, a Consensus Steering Group and a Consensus Development Group were established to determine the topics, prepare evidence-based documents, and generate recommendations. The GRADE Grid method and Delphi vote were used to formulate the recommendations. A total of 22 topics were prepared analyzed and widely discussed during the 4 meetings. Based on the published articles and expert panel opinion, 7 recommendations were generated by the GRADE method using an evidence-based method, which focused on the safety, feasibility, indication, techniques and cost-effectiveness of hepatectomy. Given that the current evidences were low to very low as evaluated by the GRADE method, further randomized-controlled trials are needed in the future to validate these recommendations. © The Author(s) 2019.
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