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Multivariate analysis of risk factors for postoperative complications after laparoscopic liver resection

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Abstract

Background

The identification of modifiable perioperative risk factors in patients undergoing laparoscopic liver resection (LLR) should aid the selection of appropriate surgical procedures and thus improve further the outcomes associated with LLR. The aim of this retrospective study was to determine the risk factors for postoperative morbidity associated with laparoscopic liver surgery.

Methods

All patients who underwent elective LLR between January 1999 and December 2012 were included. Demographic data, preoperative risk factors, operative variables, histological analysis, and postoperative course were recorded. Multivariate analysis was carried out using an unconditional logistic regression model.

Results

Between January 1999 and December 2012, 140 patients underwent LLR. There were 56 male patients (40 %) and mean age was 57.8 ± 17 years. Postoperative complications were recorded in 30 patients (21.4 %). Postoperative morbidity was significantly higher after LLR of malignant tumors [n = 26 (41.3 %)] when compared to LLR of benign lesions [n = 4 (5.2 %) (P < 0.0001)]. By multivariate analysis, operative time [OR = 1.008 (1.003–1.01), P = 0.001] and LLR performed for malignancy [OR = 9.8 (2.5–37.6); P = 0.01] were independent predictors of postoperative morbidity. In the subgroup of patients that underwent LLR for malignancy using the same multivariate model, operative time was the sole independent predictor of postoperative morbidity [OR = 1.008 (1.002–1.013); P = 0.004].

Conclusions

Postoperative complication rate increases by 60 % with each additional operative hour during LLR. Therefore, expected operative time should be assessed before and during LLR, especially when dealing with malignant tumor.

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Acknowledgments

The authors wish to thank Dr. Matthieu Faron for his advice concerning statistical analysis.

Disclosures

Hadrien Tranchart, Martin Gaillard, Mircea Chirica, Stefano Ferretti, Gabriel Perlemuter, Sylvie Naveau, and Ibrahim Dagher have no conflicts of interest or financial ties to disclose.

Author information

Authors and Affiliations

  1. Department of Minimally Invasive Digestive Surgery, Antoine Béclère Hospital, AP-HP, 92140, Clamart, France

    Hadrien Tranchart, Martin Gaillard, Mircea Chirica, Stefano Ferretti & Ibrahim Dagher

  2. Paris-Sud University, 91405, Orsay, France

    Hadrien Tranchart, Martin Gaillard, Gabriel Perlemuter, Sylvie Naveau & Ibrahim Dagher

  3. Department of Hepato-gastroenterology, Antoine Béclère Hospital, AP-HP, 92140, Clamart, France

    Gabriel Perlemuter & Sylvie Naveau

Authors
  1. Hadrien Tranchart
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  2. Martin Gaillard
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  3. Mircea Chirica
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  7. Ibrahim Dagher
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Corresponding author

Correspondence to Ibrahim Dagher.

Additional information

Hadrien Tranchart and Martin Gaillard contributed equally to this work.

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Tranchart, H., Gaillard, M., Chirica, M. et al. Multivariate analysis of risk factors for postoperative complications after laparoscopic liver resection. Surg Endosc 29, 2538–2544 (2015). https://doi.org/10.1007/s00464-014-3965-0

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  • DOI: https://doi.org/10.1007/s00464-014-3965-0

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