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Impact of tumor proximity to vessel on conversion in laparoscopic liver resection: A retrospective cohort study
Akimasa Sakamoto1, Kohei Ogawa1, Mikiya Shine1
1Department of Hepato-Biliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Journal of Hepato-Biliary-Pancreatic Sciences
|June 2, 2024
Summary
Tumor proximity to medium vessels and lower platelet counts predict conversion during laparoscopic liver resection (LLR). Keeping tumors within 10mm of vessels increases the risk of conversion to open surgery.
Area of Science:
- Hepatobiliary Surgery
- Minimally Invasive Surgery
- Surgical Oncology
Background:
- Laparoscopic liver resection (LLR) difficulty scoring systems lack detail on tumor-vessel proximity.
- Understanding factors predicting conversion to open surgery is crucial for LLR safety.
Purpose of the Study:
- To identify risk factors for conversion to open hepatectomy during LLR.
- Specifically investigate the role of tumor proximity to vessels in LLR difficulty.
Main Methods:
- Retrospective analysis of 118 patients undergoing LLR between 2012 and 2022.
- Evaluation of perioperative characteristics, focusing on tumor-vessel distance and platelet count.
Main Results:
- 8.5% of LLR cases were converted to open surgery.
- Conversion was associated with lower platelet count, greater tumor depth, and shorter tumor-to-medium vessel distance (<10mm).
- Tumor proximity within 10mm of a medium vessel and low platelet count were independent predictors of conversion.
Conclusions:
- Tumor proximity within 10mm to a medium vessel is a significant predictor of intraoperative conversion in LLR.
- Lower platelet count is also an independent risk factor for conversion during LLR.
