File Download

There are no files associated with this item.

  Links for fulltext
     (May Require Subscription)
Supplementary

Article: Laparoscopic and open liver resection for hepatocellular carcinoma with Child–Pugh B cirrhosis: multicentre propensity score-matched study

TitleLaparoscopic and open liver resection for hepatocellular carcinoma with Child–Pugh B cirrhosis: multicentre propensity score-matched study
Authors
Issue Date2021
PublisherOxford University Press: Policy B. The Journal's web site is located at https://academic.oup.com/bjs
Citation
British Journal of Surgery, 2021, v. 108 n. 2, p. 196-204 How to Cite?
AbstractBackground: Laparoscopic liver resection for hepatocellular carcinoma (HCC) in Child–Pugh A cirrhosis has been demonstrated as beneficial. However, the role of laparoscopy in Child–Pugh B cirrhosis is undetermined. The aim of this retrospective cohort study was to compare open and laparoscopic resection for HCC with Child–Pugh B cirrhosis. Methods: Data on liver resections were gathered from 17 centres. A 1 : 1 propensity score matching was performed according to 17 predefined variables. Results: Of 382 available liver resections, 100 laparoscopic and 100 open resections were matched and analysed. The 90-day postoperative mortality rate was similar in open and laparoscopic groups (4.0 versus 2.0 per cent respectively; P = 0.687). Laparoscopy was associated with lower blood loss (median 110 ml versus 400 ml in the open group; P = 0.004), less morbidity (38.0 versus 51.0 per cent respectively; P = 0.041) and fewer major complications (7.0 versus 21.0 per cent; P = 0.010), and ascites was lower on postoperative days 1, 3 and 5. For laparoscopic resections, patients with portal hypertension developed more complications than those without (26 versus 12 per cent respectively; P = 0.002), and patients with a Child–Pugh B9 score had higher morbidity rates than those with B8 and B7 (7 of 8, 10 of 16 and 21 of 76 respectively; P < 0.001). Median hospital stay was 7.5 (range 2–243) days for laparoscopic liver resection and 18 (3–104) days for the open approach (P = 0.058). The 5-year overall survival rate was 47 per cent for open and 65 per cent for laparoscopic resection (P = 0.142). The 5-year disease-free survival rate was 32 and 37 per cent respectively (P = 0.742). Conclusion: Patients without preoperative portal hypertension and Child–Pugh B7 cirrhosis may benefit most from laparoscopic liver surgery.
Persistent Identifierhttp://hdl.handle.net/10722/304762
ISSN
2020 Impact Factor: 6.939
2020 SCImago Journal Rankings: 2.202
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorTroisi, RI-
dc.contributor.authorBerardi, G-
dc.contributor.authorMorise, Z-
dc.contributor.authorCipriani, F-
dc.contributor.authorAriizumi, S-
dc.contributor.authorSposito, C-
dc.contributor.authorPanetta, V-
dc.contributor.authorSimonelli, I-
dc.contributor.authorKim, S-
dc.contributor.authorGoh, BKP-
dc.contributor.authorKubo, S-
dc.contributor.authorTanaka, S-
dc.contributor.authorTakeda, Y-
dc.contributor.authorEttorre, GM-
dc.contributor.authorRussolillo, N-
dc.contributor.authorWilson, GC-
dc.contributor.authorCimino, M-
dc.contributor.authorMontalti, R-
dc.contributor.authorGiglio, MC-
dc.contributor.authorIgarashi, K-
dc.contributor.authorChan, CY-
dc.contributor.authorTorzilli, G-
dc.contributor.authorCheung, TT-
dc.contributor.authorMazzaferro, V-
dc.contributor.authorKaneko, H-
dc.contributor.authorFerrero, A-
dc.contributor.authorGeller, DA-
dc.contributor.authorHan, HS-
dc.contributor.authorKanazawa, A-
dc.contributor.authorWakabayashi, G-
dc.contributor.authorAldrighetti, L-
dc.contributor.authorYamamoto, M-
dc.date.accessioned2021-10-05T02:34:49Z-
dc.date.available2021-10-05T02:34:49Z-
dc.date.issued2021-
dc.identifier.citationBritish Journal of Surgery, 2021, v. 108 n. 2, p. 196-204-
dc.identifier.issn0007-1323-
dc.identifier.urihttp://hdl.handle.net/10722/304762-
dc.description.abstractBackground: Laparoscopic liver resection for hepatocellular carcinoma (HCC) in Child–Pugh A cirrhosis has been demonstrated as beneficial. However, the role of laparoscopy in Child–Pugh B cirrhosis is undetermined. The aim of this retrospective cohort study was to compare open and laparoscopic resection for HCC with Child–Pugh B cirrhosis. Methods: Data on liver resections were gathered from 17 centres. A 1 : 1 propensity score matching was performed according to 17 predefined variables. Results: Of 382 available liver resections, 100 laparoscopic and 100 open resections were matched and analysed. The 90-day postoperative mortality rate was similar in open and laparoscopic groups (4.0 versus 2.0 per cent respectively; P = 0.687). Laparoscopy was associated with lower blood loss (median 110 ml versus 400 ml in the open group; P = 0.004), less morbidity (38.0 versus 51.0 per cent respectively; P = 0.041) and fewer major complications (7.0 versus 21.0 per cent; P = 0.010), and ascites was lower on postoperative days 1, 3 and 5. For laparoscopic resections, patients with portal hypertension developed more complications than those without (26 versus 12 per cent respectively; P = 0.002), and patients with a Child–Pugh B9 score had higher morbidity rates than those with B8 and B7 (7 of 8, 10 of 16 and 21 of 76 respectively; P < 0.001). Median hospital stay was 7.5 (range 2–243) days for laparoscopic liver resection and 18 (3–104) days for the open approach (P = 0.058). The 5-year overall survival rate was 47 per cent for open and 65 per cent for laparoscopic resection (P = 0.142). The 5-year disease-free survival rate was 32 and 37 per cent respectively (P = 0.742). Conclusion: Patients without preoperative portal hypertension and Child–Pugh B7 cirrhosis may benefit most from laparoscopic liver surgery.-
dc.languageeng-
dc.publisherOxford University Press: Policy B. The Journal's web site is located at https://academic.oup.com/bjs-
dc.relation.ispartofBritish Journal of Surgery-
dc.titleLaparoscopic and open liver resection for hepatocellular carcinoma with Child–Pugh B cirrhosis: multicentre propensity score-matched study-
dc.typeArticle-
dc.identifier.emailCheung, TT: cheung68@hku.hk-
dc.identifier.authorityCheung, TT=rp02129-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1093/bjs/znaa041-
dc.identifier.pmid33711132-
dc.identifier.scopuseid_2-s2.0-85102915580-
dc.identifier.hkuros326216-
dc.identifier.volume108-
dc.identifier.issue2-
dc.identifier.spage196-
dc.identifier.epage204-
dc.identifier.isiWOS:000637024200045-
dc.publisher.placeUnited Kingdom-

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats