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Near-zero open conversion rate of laparoscopic liver resection: a high-volume single-center experience of the past 5 years

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Abstract

Background

Despite widespread adoption and technological advances in laparoscopic liver resection (LLR), conversion to laparotomy can still occur unexpectedly. Several studies have explored risk factors of open conversion (OC). However, most of these studies were conducted before 2018 and included all patients who underwent surgery at an early stage after starting LLR. The purpose of this study was to analyze the incidence and risk factors of OC in patients within the past 5 years (2017–2021).

Methods

Patients who underwent LLR at Samsung Medical Center from January 2017 to December 2021 were investigated. The incidence and causes of OC were investigated and risk factors associated with OC were also analyzed.

Results

A total of, 1951 patients were investigated. OC was observed in 34 patients (1.74%). The percentage of previous surgeries (50% vs. 25.5%, P < 0.001), history of hepatectomy (23.5% vs. 5.4%, P = 0.002), multi-focal disease (29.4% vs. 13.9%, P = 0.037), and posterosuperior (PS) location (64.7% vs. 39%, P = 0.004) were higher in the OC group. The most common cause of OC was adhesion (44.1%). In the analysis of risk factors associated with OC, PS location (OR 2.79, P = 0.007) and maximum tumor size (OR 0.92, P = 0.037) were statistically significant factors in multivariate analysis.

Conclusion

The updated incidence of OC was 1.74%. The main cause of OC was adhesion. In addition, PS location and smaller tumor size were risk factors associated with OC.

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Abbreviations

LLR:

Laparoscopic liver resection

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Authors and Affiliations

  1. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea

    Sung Jun Jo, Jinsoo Rhu, Jong Man Kim, Gyu-seong Choi & Jae-Won Joh

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  1. Sung Jun Jo
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  2. Jinsoo Rhu
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  3. Jong Man Kim
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  4. Gyu-seong Choi
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  5. Jae-Won Joh
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Correspondence to Jinsoo Rhu.

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Disclosures

Sung Jun Jo, Jinsoo Rhu, Jong Man Kim, Gyu-seong Choi, and Jae-Won Joh have no conflicts of interest or financial ties to disclose.

Ethical approval

The study protocol conformed to the ethical guidelines of the Declaration of Helsinki and was approved by the Institutional Review Board of Samsung Medical Center (IRB No. SMC 2022-05-076).

Informed consernt

The need for informed consent was waived by the Institutional Review Board of Samsung Medical Center due to the retrospective nature of the study.

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Jo, S.J., Rhu, J., Kim, J.M. et al. Near-zero open conversion rate of laparoscopic liver resection: a high-volume single-center experience of the past 5 years. Surg Endosc 37, 1813–1821 (2023). https://doi.org/10.1007/s00464-022-09661-5

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  • DOI: https://doi.org/10.1007/s00464-022-09661-5

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