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Defining Global Benchmarks for Laparoscopic Liver Resections: An International Multicenter Study.
Brian K P Goh1, Ho-Seong Han2, Kuo-Hsin Chen3
1Department of Hepatopancreatobiliary and Transplant Surgery,, Singapore General Hospital, National Cancer Centre Singapore and Duke-National University of Singapore Medical School, Singapore, Singapore.
This study sets global benchmarks for laparoscopic liver resections (L-LR), defining best achievable outcomes for left lateral sectionectomy, left hepatectomy, and right hepatectomy procedures. These benchmarks aid centers in assessing performance and identifying learning curves for L-LR.
Area of Science:
- Hepatobiliary Surgery
- Minimally Invasive Surgery
- Surgical Outcomes Research
Background:
- Limited data exists on optimal outcomes for laparoscopic liver resections (L-LR).
- Establishing global benchmarks is crucial for evaluating L-LR performance.
- Standardized outcome indicators are needed for L-LR quality assessment.
Purpose of the Study:
- To establish global benchmark outcome indicators for laparoscopic liver resections (L-LR).
- To define the "best achievable" results for L-LR across different procedure complexities.
- To provide a reference for centers performing L-LR to assess their performance.
Main Methods:
- Post hoc analysis of a multicenter database (11,983 patients, 45 international centers, 2015-2020).
- Selection of three representative L-LR procedures: left lateral sectionectomy (LLS), left hepatectomy (LH), and right hepatectomy (RH).
- Identification of 15 outcome indicators to establish benchmark cutoffs for low-risk cases.
Main Results:
- Analysis included 3519 L-LR cases, with 1258 (40.6%) from benchmark expert centers.
- Benchmark outcomes were established for operation time, open conversion, blood loss, transfusion, morbidity, and mortality for LLS, LH, and RH.
- Specific benchmark values were determined for each outcome indicator and procedure type.
Conclusions:
- This study presents the first global benchmarks for L-LR outcomes using a large international cohort.
- These benchmarks serve as a vital reference for centers to objectively assess performance and learning curves.
- The findings facilitate the standardization and improvement of L-LR quality worldwide.
