Impact of cirrhosis in patients undergoing laparoscopic liver resection in a nationwide multicentre survey.

Autor: Hobeika C; Department of Hepatobiliary and Pancreatic Surgery and Liver Transplantation, Sorbonne Université, Centre de Recherche Scientifique Saint Antoine, Hôpital Pitié Salpétrière, Paris, France., Fuks D; Department of Digestive, Oncological and Metabolic Surgery, Institut Mutualiste Montsouris, University Paris Descartes, Paris, France., Cauchy F; Department of Hepatobiliary and Pancreatic Surgery and Liver Transplantation, Hôpital Beaujon, Clichy, France., Goumard C; Department of Hepatobiliary and Pancreatic Surgery and Liver Transplantation, Sorbonne Université, Centre de Recherche Scientifique Saint Antoine, Hôpital Pitié Salpétrière, Paris, France., Soubrane O; Department of Hepatobiliary and Pancreatic Surgery and Liver Transplantation, Hôpital Beaujon, Clichy, France., Gayet B; Department of Digestive, Oncological and Metabolic Surgery, Institut Mutualiste Montsouris, University Paris Descartes, Paris, France., Salamé E; Department of Digestive Surgery and Liver Transplantation, Trousseau University Hospital, Tours University, Tours, France., Cherqui D; Department of Hepatobiliary and Pancreatic Surgery and Liver Transplantation, Centre Hépato-biliaire de Paul Brousse, Villejuif, France., Vibert E; Department of Hepatobiliary and Pancreatic Surgery and Liver Transplantation, Centre Hépato-biliaire de Paul Brousse, Villejuif, France., Scatton O; Department of Hepatobiliary and Pancreatic Surgery and Liver Transplantation, Sorbonne Université, Centre de Recherche Scientifique Saint Antoine, Hôpital Pitié Salpétrière, Paris, France., Nomi T; Nara Medical University, Nara, Japan., Oudafal N; Institut Mutualiste Montsouris, Paris, France., Kawai T; Pitié Salpétrière Hospital, Assistance Publique - Hôpitaux de Paris (APHP), Paris, France., Komatsu S; Pitié Salpétrière Hospital, Assistance Publique - Hôpitaux de Paris (APHP), Paris, France., Okumura S; Pitié Salpétrière Hospital, Assistance Publique - Hôpitaux de Paris (APHP), Paris, France., Petrucciani N; Hôpital Henri Mondor, APHP, Creteil, France., Laurent A; Hôpital Henri Mondor, APHP, Creteil, France., Bucur P; Trousseau Hospital, University Hospital Centre of Tours, Tours, France., Barbier L; Trousseau Hospital, University Hospital Centre of Tours, Tours, France., Trechot B; Centre Hépato-biliaire de Paul Brousse, APHP, Villejuif, France., Nunèz J; Centre Hépato-biliaire de Paul Brousse, APHP, Villejuif, France., Tedeschi M; Centre Hépato-biliaire de Paul Brousse, APHP, Villejuif, France., Allard MA; Centre Hépato-biliaire de Paul Brousse, APHP, Villejuif, France., Golse N; Centre Hépato-biliaire de Paul Brousse, APHP, Villejuif, France., Ciacio O; Centre Hépato-biliaire de Paul Brousse, APHP, Villejuif, France., Pittau G; Centre Hépato-biliaire de Paul Brousse, APHP, Villejuif, France., Cunha AS; Centre Hépato-biliaire de Paul Brousse, APHP, Villejuif, France., Adam R; Centre Hépato-biliaire de Paul Brousse, APHP, Villejuif, France., Laurent C; Hospital University Centre of Bordeaux, Bordeaux, France., Chiche L; Hospital University Centre of Bordeaux, Bordeaux, France., Leourier P; Hospital University Centre of Amiens-Picardie, Amiens, France., Rebibo L; Hospital University Centre of Amiens-Picardie, Amiens, France., Regimbeau JM; Hospital University Centre of Amiens-Picardie, Amiens, France., Ferre L; Saint Eloi Hospital, Hospital University Centre of Montpellier, Montpellier, France., Souche FR; Saint Eloi Hospital, Hospital University Centre of Montpellier, Montpellier, France., Chauvat J; Saint Eloi Hospital, Hospital University Centre of Montpellier, Montpellier, France., Fabre JM; Saint Eloi Hospital, Hospital University Centre of Montpellier, Montpellier, France., Jehaes F; Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France., Mohkam K; Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France., Lesurtel M; Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France., Ducerf C; Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France., Mabrut JY; Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France., Hor T; St Antoine Hospital, APHP, Paris, France., Paye F; St Antoine Hospital, APHP, Paris, France., Balladur P; St Antoine Hospital, APHP, Paris, France., Suc B; Rangueil Hospital, Hospital University Centre of Toulouse, Toulouse, France., Muscari F; Rangueil Hospital, Hospital University Centre of Toulouse, Toulouse, France., Millet G; Claude Huriez Hospital, Hospital University Centre of Lille, Lille, France., El Amrani M; Claude Huriez Hospital, Hospital University Centre of Lille, Lille, France., Ratajczak C; Claude Huriez Hospital, Hospital University Centre of Lille, Lille, France., Lecolle K; Claude Huriez Hospital, Hospital University Centre of Lille, Lille, France., Boleslawski E; Claude Huriez Hospital, Hospital University Centre of Lille, Lille, France., Truant S; Claude Huriez Hospital, Hospital University Centre of Lille, Lille, France., Pruvot FR; Claude Huriez Hospital, Hospital University Centre of Lille, Lille, France., Kianmanesh AR; Robert Debré Hospital, Hospital University Centre of Reims, Reims, France., Codjia T; Charles Nicolle Hospital, Hospital University Centre of Rouen, Rouen, France., Schwarz L; Charles Nicolle Hospital, Hospital University Centre of Rouen, Rouen, France., Girard E; Michalon Hospital, Hospital University Centre of Grenoble, Grebnoble, France., Abba J; Michalon Hospital, Hospital University Centre of Grenoble, Grebnoble, France., Letoublon C; Michalon Hospital, Hospital University Centre of Grenoble, Grebnoble, France., Chirica M; Michalon Hospital, Hospital University Centre of Grenoble, Grebnoble, France., Carmelo A; Hôpital Européen, Marseille, France., VanBrugghe C; Hôpital Européen, Marseille, France., Cherkaoui Z; Nouvel Hôpital Civil, Hospital University Centre of Strasbourg, Strasbourg, France., Unterteiner X; Nouvel Hôpital Civil, Hospital University Centre of Strasbourg, Strasbourg, France., Memeo R; Nouvel Hôpital Civil, Hospital University Centre of Strasbourg, Strasbourg, France., Pessaux P; Nouvel Hôpital Civil, Hospital University Centre of Strasbourg, Strasbourg, France., Buc E; Hospital University Centre of Clermont-Ferrand, Clermont-Ferrand, France., Lermite E; Hospital University Centre of Angers, Angers, France., Barbieux J; Hospital University Centre of Angers, Angers, France., Bougard M; Hospital University Centre of Angers, Angers, France., Marchese U; Institut Paoli-Calmettes, Marseille, France., Ewald J; Institut Paoli-Calmettes, Marseille, France., Turini O; Institut Paoli-Calmettes, Marseille, France., Thobie A; Hospital University Centre of Caen Normandie, Caen, France., Menahem B; Hospital University Centre of Caen Normandie, Caen, France., Mulliri A; Hospital University Centre of Caen Normandie, Caen, France., Lubrano J; Hospital University Centre of Caen Normandie, Caen, France., Zemour J; Hospital University Centre of Saint-Pierre, Saint Pierre, Department of Réunion, France., Fagot H; Hospital University Centre of Saint-Pierre, Saint Pierre, Department of Réunion, France., Passot G; Hospital University Centre of Lyon Sud, Lyon, France., Gregoire E; La Timone Hospital, Hospital University Centre of Marseille, Marseille, France., Hardwigsen J; La Timone Hospital, Hospital University Centre of Marseille, Marseille, France., le Treut YP; La Timone Hospital, Hospital University Centre of Marseille, Marseille, France., Patrice D; Louis Pasteur Hospital, Colmar, France.
Jazyk: angličtina
Zdroj: The British journal of surgery [Br J Surg] 2020 Feb; Vol. 107 (3), pp. 268-277. Date of Electronic Publication: 2020 Jan 09.
DOI: 10.1002/bjs.11406
Abstrakt: Background: The aim was to analyse the impact of cirrhosis on short-term outcomes after laparoscopic liver resection (LLR) in a multicentre national cohort study.
Methods: This retrospective study included all patients undergoing LLR in 27 centres between 2000 and 2017. Cirrhosis was defined as F4 fibrosis on pathological examination. Short-term outcomes of patients with and without liver cirrhosis were compared after propensity score matching by centre volume, demographic and tumour characteristics, and extent of resection.
Results: Among 3150 patients included, LLR was performed in 774 patients with (24·6 per cent) and 2376 (75·4 per cent) without cirrhosis. Severe complication and mortality rates in patients with cirrhosis were 10·6 and 2·6 per cent respectively. Posthepatectomy liver failure (PHLF) developed in 3·6 per cent of patients with cirrhosis and was the major cause of death (11 of 20 patients). After matching, patients with cirrhosis tended to have higher rates of severe complications (odds ratio (OR) 1·74, 95 per cent c.i. 0·92 to 3·41; P = 0·096) and PHLF (OR 7·13, 0·91 to 323·10; P = 0·068) than those without cirrhosis. They also had a higher risk of death (OR 5·13, 1·08 to 48·61; P = 0·039). Rates of cardiorespiratory complications (P = 0·338), bile leakage (P = 0·286) and reoperation (P = 0·352) were similar in the two groups. Patients with cirrhosis had a longer hospital stay than those without (11 versus 8 days; P = 0·018). Centre expertise was an independent protective factor against PHLF in patients with cirrhosis (OR 0·33, 0·14 to 0·76; P = 0·010).
Conclusion: Underlying cirrhosis remains an independent risk factor for impaired outcomes in patients undergoing LLR, even in expert centres.
(© 2020 BJS Society Ltd Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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