Nadia Russolillo1,2, Michele Casella3, Serena Langella3, Roberto Lo Tesoriere3, Paolo Ossola3, Alessandro Ferrero3. 1. Department of General and Oncological Surgery, Mauriziano Hospital, Turin, Italy. nrussolillo@mauriziano.it. 2. Department of General and Oncological Surgery, Umberto I Mauriziano Hospital Largo Turati, 62-10128, Turin, Italy. nrussolillo@mauriziano.it. 3. Department of General and Oncological Surgery, Mauriziano Hospital, Turin, Italy.
Abstract
PURPOSE: The difficulty of laparoscopic right liver resections (LRLR) is mainly associated with their poor accessibility. Anthropometric data rather than BMI was reported to predict transection time and blood loss. Aim of the study was to evaluate the correlation between anthropometric data and preparatory manoeuvres difficulties during LRLR. METHODS: All patients who underwent LRLR requiring full right liver mobilization from November 2019 to March 2021 were prospectively included in the study. Data on surgeons' difficulty perceptions on liver mobilization (LM), isolation of right hepatic vein (RHVI), liver manageability and visibility were rated with a 5-point scale. Data on cranio-caudal liver diameters (CCliv), CHALLENGE Index (CCliv/latero-lateral abdomen diameter), times needed to LM and RHVI were collected. RESULTS: Sixty-five patients (29 wedge and 36 anatomical resections) with a median BMI of 25.5 were analysed. One patient required open conversion due to oncological reason. No correlations between BMI and CCliv or CHALLENGE Index were found. Larger CCliv diameter correlated with longer time for both RHVI (r = 0.589, p = 0.002) and LM (r = 0.222, p = 0.049). Higher CHALLENGE index correlated with longer time for RHVI (r = 0.589, p = 0.002). The CHALLENGE index showed a linear correlation with difficulty to the isolation of RHV (r = 0.327, p = 0.045), whilst the liver manipulation difficulty increased with latero-lateral liver diameter (r = 0.244, p = 0.033). BMI had no correlation with the duration of preparatory maneuvers neither with surgeons' difficulties. CONCLUSIONS: Anthropometric data can help to anticipate the difficulty of preparatory maneuvers during laparoscopic right liver resections.
PURPOSE: The difficulty of laparoscopic right liver resections (LRLR) is mainly associated with their poor accessibility. Anthropometric data rather than BMI was reported to predict transection time and blood loss. Aim of the study was to evaluate the correlation between anthropometric data and preparatory manoeuvres difficulties during LRLR. METHODS: All patients who underwent LRLR requiring full right liver mobilization from November 2019 to March 2021 were prospectively included in the study. Data on surgeons' difficulty perceptions on liver mobilization (LM), isolation of right hepatic vein (RHVI), liver manageability and visibility were rated with a 5-point scale. Data on cranio-caudal liver diameters (CCliv), CHALLENGE Index (CCliv/latero-lateral abdomen diameter), times needed to LM and RHVI were collected. RESULTS: Sixty-five patients (29 wedge and 36 anatomical resections) with a median BMI of 25.5 were analysed. One patient required open conversion due to oncological reason. No correlations between BMI and CCliv or CHALLENGE Index were found. Larger CCliv diameter correlated with longer time for both RHVI (r = 0.589, p = 0.002) and LM (r = 0.222, p = 0.049). Higher CHALLENGE index correlated with longer time for RHVI (r = 0.589, p = 0.002). The CHALLENGE index showed a linear correlation with difficulty to the isolation of RHV (r = 0.327, p = 0.045), whilst the liver manipulation difficulty increased with latero-lateral liver diameter (r = 0.244, p = 0.033). BMI had no correlation with the duration of preparatory maneuvers neither with surgeons' difficulties. CONCLUSIONS: Anthropometric data can help to anticipate the difficulty of preparatory maneuvers during laparoscopic right liver resections.
Authors: Mohammad Abu Hilal; Luca Aldrighetti; Ibrahim Dagher; Bjorn Edwin; Roberto Ivan Troisi; Ruslan Alikhanov; Somaiah Aroori; Giulio Belli; Marc Besselink; Javier Briceno; Brice Gayet; Mathieu D'Hondt; Mickael Lesurtel; Krishna Menon; Peter Lodge; Fernando Rotellar; Julio Santoyo; Olivier Scatton; Olivier Soubrane; Robert Sutcliffe; Ronald Van Dam; Steve White; Mark Christopher Halls; Federica Cipriani; Marcel Van der Poel; Ruben Ciria; Leonid Barkhatov; Yrene Gomez-Luque; Sira Ocana-Garcia; Andrew Cook; Joseph Buell; Pierre-Alain Clavien; Christos Dervenis; Giuseppe Fusai; David Geller; Hauke Lang; John Primrose; Mark Taylor; Thomas Van Gulik; Go Wakabayashi; Horacio Asbun; Daniel Cherqui Journal: Ann Surg Date: 2018-07 Impact factor: 12.969
Authors: M L Kromrey; T Ittermann; C vWahsen; V Plodeck; D Seppelt; R T Hoffmann; P Heiss; J P Kühn Journal: Eur J Radiol Date: 2018-07-07 Impact factor: 3.528