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The differential benefit of laparoscopic over open minor liver resection for lesions situated in the anterolateral or posterosuperior segments

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Hepatobiliary Surgery and Nutrition 2024年第4期13卷 604-615,I0015-I0021页

作者： Jasper P.Sijberden Guido Fiorentini Jacopo Lanari Davit Aghayan Daniel Osei-Bordom Nadia Russolillo Arjun Takhar andrea benedetti cacciaguerra Santi Lopez-Ben Mathieu D’Hondt Felice Giuliante David Fuks Fernando Rotellar andrea Ruzzenente Adnan Alseidi Mikhail Efanov Burak Görgec Giuseppe Zimmitti Enrico Gringeri Federica Cipriani Åsmund Avdem Fretland Ravi Marudanayagam Marco Vivarelli John N.Primrose Alessandro Ferrero Robert P.Sutcliffe Bjørn Edwin Umberto Cillo Marc G.Besselink Mohammad Abu Hilal Luca A.Aldrighetti Department of Surgery Fondazione Poliambulanza Istituto OspedalieroBresciaItaly Amsterdam UMC location University of Amsterdam Department of SurgeryAmsterdamthe Netherlands Cancer Center Amsterdam Amsterdamthe Netherlands Hepatobiliary Surgery Division IRCCS San Raffaele HospitalMilanItaly Department of Surgical Oncological and Gastroenterological SciencesGeneral Surgery 2Hepatobiliary Surgery and Liver TransplantationPadua University HospitalPaduaItaly The Intervention Centre and Department of HPB Surgery Oslo University Hospital and Institute of Clinical MedicineUniversity of OsloOsloNorway Department of Surgery Ringerike HospitalVestre Viken Hospital TrustDrammenNorway Liver Unit Queen Elizabeth HospitalBirminghamUK Department of General and Oncological Surgery Umberto I Mauriziano HospitalLargo TuratiTurinItaly Department of Surgery University Hospital Southampton NHS Foundation TrustSouthamptonUK Hepatobiliary and Abdominal Transplantation Surgery Department of Experimental and Clinical MedicineRiuniti HospitalPolytechnic University of MarcheAnconaItaly Servei de Cirurgia General i Digestiva Hospital Doctor Josep Trueta de GironaGironaCataloniaSpain Department of Digestive and Hepatobiliary/Pancreatic Surgery Groeninge HospitalKortrijkBelgium Chirurgia Epatobiliare UniversitàCattolica del Sacro Cuore-IRCCSRomeItaly Department of Digestive Oncologic and Metabolic SurgeryInstitut Mutualiste MontsourisUniversitéParis DescartesParisFrance HPB and Liver Transplantation Unit Department of SurgeryUniversity ClinicUniversidad de NavarraNavarraSpain Institute of Health Research of Navarra(IdisNA) PamplonaSpain Department of Surgery University of VeronaVeronaItaly Department of Surgery Virginia Mason Medical CenterSeattleWAUSA Department of Surgery University of California San FranciscoSan FranciscoCAUSA Department of Hepato-Pancreato-Biliary Surgery Moscow Clinical Research CentreMoscowRussia

Background:It is well known that laparoscopic liver surgery can offer advantages over open liver surgery in selected ***,what type of procedures can benefit most from a laparoscopic approach has been investigated poorly thus *** aim of this study is thus to define the extent of advantages of laparoscopic over open liver surgery for lesions in the anterolateral(AL)and posterosuperior(PS)***:In this international multicentre retrospective cohort study,laparoscopic and open minor liver resections for lesions in the AL and PS segments were compared after propensity score *** differential benefit of laparoscopy over open liver surgery,calculated using bootstrap sampling,was compared between AL and PS resections and expressed as a Delta of the ***:After matching,3,040 AL and 2,336 PS resections were compared,encompassing open and laparoscopic procedures in a 1:1 *** and PS laparoscopic liver resections were more advantageous in comparison to open in terms of blood loss,transfusion rate,complications,and length of ***,AL resections benefitted more from laparoscopy than PS in terms of overall and severe complications(D-difference were 4.8%,P=0.046 and 3%,P=0.046)and blood loss(D-difference was 195 mL,P<0.001).Similar results were observed in the subset for high-volume centres,while in recent years no significant differences were found in the differential benefit between AL and PS ***:The advantage of laparoscopic over open liver surgery is greater in the AL segments than in the PS segments.

关键词： Liver neoplasms hepatectomy laparoscopic liver resection open liver resection

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Intraductal papillary neoplasm of the bile duct:The new frontier of biliary pathology

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World Journal of Gastroenterology 2023年第38期29卷 5361-5373页

作者： Federico Mocchegiani Paolo Vincenzi Grazia Conte Daniele Nicolini Roberta Rossi andrea benedetti cacciaguerra Marco Vivarelli Department of Experimental and Clinical Medicine Polytechnic University of MarcheAncona 60126Italy Department of Gastroenterology and Transplant United Hospital of MarcheAncona 60126Italy

Intraductal papillary neoplasms of the bile duct(IPNBs)represent a rare variant of biliary tumors characterized by a papillary growth within the bile duct *** their first description in 2001,several classifications have been proposed,mainly based on histopathological,radiological and clinical features,although no specific guidelines addressing their management have been *** duct neoplasms generally develop through a multistep process,involving different precursor pathways,ranging from the initial lesion,detectable only microscopically,*** intraepithelial neoplasia,to the distinctive grades of IPNB until the final stage represented by invasive *** and advanced investigations,mainly relying on magnetic resonance imaging(MRI)and cholangioscopy,are required to reach a correct diagnosis and to define an adequate bile duct mapping,which supports proper *** recently introduced subclassifications of types 1 and 2 highlight the histopathological and clinical aspects of IPNB,as well as their natural evolution with a particular focus on prognosis and *** surgical resection,including hepatectomy,pancreaticoduodenectomy or both,represents the treatment of choice,yielding optimal results in terms of survival,although several endoscopic approaches have been *** are newly recognized preinvasive neoplasms of the bile duct with high malignant *** novel subclassification of types 1 and 2 defines the histological and clinical aspects,prognosis and *** is mainly based on MRI and *** resection represents the mainstay of treatment,although endoscopic resection is currently applied to nonsurgically fit *** frontiers in genetic research have identified the processes underlying the carcinogenesis of IPNB,to identify targeted therapies.

关键词： Intraductal neoplasm of the bile duct Bile duct neoplasms Cholangiocarcinoma Intraductal papilloma Classification Treatment

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