Research Article
Volume 4 Issue 2 - 2021
Comparison of Outcomes in Major and Minor Hepatectomies Between Minimally Invasive Versus Open Surgical Techniques: NSQIP Database, 2015
Yana Puckett*, Theophilus Pham, Quang Nguyen, Catherine A Ronaghan and Edwin Onkendi
Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, TX, USA
*Corresponding Author: Yana Puckett, Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
Received: November 16, 2020; Published: January 27, 2021




Abstract

Introduction: Minimally invasive surgery (MIS) to treat liver disease has increased in prevalence over the past decade; however, little data exists comparing outcomes between MIS and open hepatectomies. We sought to compare preoperative and postoperative outcomes between MIS and open hepatectomies performed for hepatobiliary malignancies.

Methods: The National Surgical Quality Improvement Program (NSQIP) Database was used to analyze all patients who underwent hepatectomies between January 1 and December 31, 2015. Hepatectomies were divided into three groups (open, laparoscopic, robotic). Preoperative variables such as pringle maneuver usage, concurrent ablation, concurrent hepaticojejunostomy, whether neoadjuvant therapy was used were compared between MIS and open hepatectomies. Perioperative outcomes such as conversion from laparoscopic or robotic to open, bile leakage, drain placement, INR, bilirubin (drain and serum), number of days of drain removal after surgery, post-hepatectomy liver failure, need for invasive intervention postoperatively, and pathology results were are compared. Groups were further dichotomized into major (> 3 liver segments resected) versus minor (1 - 2 liver segments resected) liver hepatectomies.

Results: A total of 1,010 patients were analyzed. Hepatocellular carcinoma comprised 58.91% (Drain placement, peak postoperative bilirubin, need for invasive intervention postoperatively, bile leakage, post-hepatectomy liver failure were all significantly lower in MIS hepatectomies compared to open (< 0.0001).

Conclusion: Overall, MIS hepatectomies performed for hepatobiliary malignancies were found to have lower complication rate in both major and minor hepatic resections. When possible, MIS surgery should be attempted in all hepatectomy patients.

Keywords:Minimally Invasive Surgery (MIS); National Surgical Quality Improvement Program (NSQIP); Open Surgical Techniques

References

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Citation: Yana Puckett.,et al. “Comparison of Outcomes in Major and Minor Hepatectomies Between Minimally Invasive Versus Open Surgical Techniques: NSQIP Database, 2015”. EC Clinical and Medical Case Reports 4.2 (2020): 04-12.

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