Journal of Laparoendoscopic & Advanced Surgical Techniques · 2016 · 10 citations · 30 references
MedicineSurgeryHepatologyMicrosurgeryPerioperative Outcomes ResearchHepatobiliary DiseaseHepatobiliary SurgeryPostoperative ComplicationsHepatobiliary InterventionHepatopancreatobiliary SurgeryLaparoscopic HepatectomyPost-publication ReviewPropensity Score Adjustment
PURPOSE: Bilateral hepatolithiasis tends to show recurrent attacks, which may lead to liver damage and bile duct cancer. This study aimed to assess long-term outcome of hepatectomy for bilateral hepatolithiasis based on three-dimensional reconstruction. METHOD: A total of 258 bilateral hepatolithiasis patients were enrolled in this retrospective study from January 2008 to October 2014. There are 74 individuals in Three-Divisional Visualization System (MI-3DVS) group (group A) and 74 individuals in non-MI-3DVS group (group B) after propensity score matching (PSM), respectively. Then, complication incidence, stone clearance, recurrence, and recurrence-free survival rates were compared between the two groups. Multivariate Cox analysis was used to test impact of MI-3DVS on recurrence-free survival (RFS). RESULTS: The Median (Range) volumes of intraoperative blood loss were 300 (30-1050) and 400 (50-1800) mL in group A and B, respectively (P = .037). Meanwhile, immediate clearance (77% versus 53%, P = .002) and final clearance (95% versus 80%, P = .007) rates were higher in group A compared with values obtained for group B. Multivariate Cox analysis showed non-MI-3DVS (HR = 2.00, 95% confidence interval [CI] = 1.02-3.95, P = .045) and patients with bilateral cirrhosis (Hazard Ratio [HR] = 10.60, 95% CI = 4.45-25.25, P < .001) were independent predictors of RFS. CONCLUSION: Compared with conventional radiological technology, MI-3DVS-based hepatectomy resulted in higher stone clearance rate of bilateral hepatolithiasis patients. Non-MI-3DVS and patients with bilateral cirrhosis were independent predictors for recurrence-free survival.
30
The Clavien-Dindo Classification of Surgical Complications
Pierre A. Clavien, Jeffrey Barkun, Michelle Oliveira et al. · Annals of Surgery · 2009 · 11.3K citations
Yan Li, Ying Yang, Ming Lu et al. · Hepatogastroenterology · 2011 · 2.4K citations