International consensus statement on robotic hepatectomy surgery in 2018

Liu, Rong; Wakabayashi, Go; Kim, Hong-Jin; Choi, Gi-Hong; Yiengpruksawan, Anusak; Fong, Yuman; He, Jin; Boggi, Ugo; Troisi, Roberto; Ефанов, Михаил; Azoulay, Daniel; Panaro, Fabrizio; Pessaux, Patrick; Wang, Xiaoying; Zhu, Jinmin; Zhang, Shaogeng; Sun, Chuandong; Wu, Zheng; Tao, Kaishan; Yang, Kehu; Fan, Jia; Chen, Xiaoping

doi:10.3748/wjg.v25.i12.1432

Cited by 160 publications

(147 citation statements)

References 83 publications

(84 reference statements)

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“…49 A recent consensus states that robotic LR is safe and has similar effectiveness to open hepatectomy in patients with hepatic malignances, although the level of evidence supporting this assertion is very low. 50…”

Section: Role Of Lymphadenectomymentioning

confidence: 99%

Liver resection and transplantation for intrahepatic cholangiocarcinoma

Mazzaferro

Gorgen

Roayaie

et al. 2020

Journal of Hepatology

228

182

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The incidence of intrahepatic cholangiocarcinoma (iCCA) is increasing worldwide. Although several advances have been made in the past decades to better understand this complex malignancy and to develop new treatment strategies, the prognosis of iCCA remains dismal. Liver resection (LR) is the mainstay of treatment but only a minority of patients are amenable to surgery. In most cases, patients with iCCA will require a major hepatectomy for complete resection of the tumour. This may be contraindicated or increase the surgical burden in patients with chronic liver disease and small remnant liver volume. Lymphadenectomy with a minimal harvest of 6 lymph nodes is considered adequate, as microscopic nodal metastases have been shown in more than 40% of patients. Current 5-year overall survival following LR is in the range of 25%-40%. For locally advanced disease not amenable to upfront LR, neoadjuvant locoregional therapies may be used with the aim of converting these patients to resectability or even to transplantation in well-selected cases. Recent studies have shown that liver transplantation (LT) might be a treatment option for patients with unresectable very-early iCCA (i.e. < − 2 cm), with survival outcomes comparable to those of hepatocellular carcinoma. In patients with unresectable, advanced tumours, confined to the liver who achieve sustained response to neoadjuvant treatment, LT may be considered an option within prospective protocols. The role of adjuvant therapies in iCCA is still under debate. Herein, we review the recent advances in the surgical treatment of iCCA and examine its correlation with locoregional therapies, adjuvant and neo-adjuvant strategies.

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Section: Role Of Lymphadenectomymentioning

confidence: 99%

Liver resection and transplantation for intrahepatic cholangiocarcinoma

Mazzaferro

Gorgen

Roayaie

et al. 2020

Journal of Hepatology

228

182

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“…Moreover, our department led the drafting and development of an international expert consensus on robotic pancreatic and robotic hepatectomy surgery. 25,26 Robotic surgery is as safe as laparoscopic and open surgery, with comparable intraoperative blood loss, length of hospital stay (LOS), overall postoperative complication rate, perioperative mortality, and rate of postoperative pancreatic stula (POPF) to laparoscopic surgery.…”

Section: Discussionmentioning

confidence: 99%

A Single-Center Retrospective and Descriptive Study of Hepatobiliary and Pancreatic Surgical Oncology during the COVID-19 Epidemic

Zhao

Zhang

et al. 2020

Preprint

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Objective: In the battle against COVID-19, most medical resources in China have been directed to infected patients in Wuhan. Thus, patients with hepatobiliary pancreatic tumors who are not suffering from COVID-19 are often not given timely and effective anti-cancer treatments. In this study, we aimed to describe clinical characteristics, treatment, and outcomes of patients with hepatobiliary and pancreatic oncology from our department, which retained normal working during the COVID-19 epidemic. We also sought to formulate a set of standardized hospitalization and treatment processes.Methods: A retrospective and descriptive study was conducted involving patients hospitalized from February 1, 2020, to February 29, 2020 (Return to work after the Spring Festival), at our Department of Hepatobiliary and Pancreatic Surgical Oncology. Results: The study included 92 patients from 12 provinces in the north of China who underwent surgical resection at our Department of Hepatobiliary and Pancreatic Surgical Oncology during the COVID-19 epidemic. Robotic surgery was performed on 82% (75/92) of patients, while the rest underwent laparoscopic (2/92) and open surgery (15/92). Eighty-six patients had malignant tumor, and six had emergency benign diseases. Only five patients had severe pancreatic fistula, and three had biliary fistula after operation. Conclusions: The standardized hospitalization and treatment processes described in this study could prevent cross-infection of patients and still ensure timely treatment of patients with hepatobiliary and pancreatic cancers. These study findings will guide the management of surgical oncology departments and treatment of patients with hepatobiliary and pancreatic oncology during serious epidemics.

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“…All the patients with PHC underwent the Kausch-Whipple procedure and standard lymphadenectomy along the right side of the superior mesenteric artery, the hepatoduodenal ligament, and the celiac trunk/upper pancreatic margin. PHC was confirmed histopathologically and classified according to the criteria of World Health Organization and the American Joint Committee on Cancer (AJCC) (13,14). Patients who underwent preoperative chemoradiation were excluded since it affects the ratio of fibrosis to cancer cells (15).…”

Section: Methodsmentioning

confidence: 99%

Prognostic significance of peritumoral fibrosis after resection of pancreatic head cancer

et al. 2019

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Prognostic value of peritumoral fibrosis (PF) in pancreatic head cancer after resection was evaluated. A total of 143 pancreatic cancer patients who underwent tumor resection were enrolled. All patients underwent routine preoperative examination, including contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI). Patients receiving preoperative chemoradiation were excluded because it affects the proportion of fibrosis and cancer cells. Histopathological confirmation and classification of pancreatic head cancer (PHC) was made according to the standards of World Health Organization and the American Joint Committee on Cancer (AJCC). The presence of fibrosis was assessed histologically, and correlated with the clinicopathological characteristics and overall survival using univariate Kaplan-Meier analysis and a stepwise multivariable Cox regression model. Vein resection, resection margin, grading, nodal status, preoperative CA19-9 levels and PF were significantly associated with overall survival. Multivariate analysis showed that all the aforementioned were independent predictive factors of survival. In addition, the survival of patients with PF was significantly worse compared to those without (HR 1.392; P=0.027). Tumor necrosis is a valuable prognostic tool that can be included in the routine post-resection histopathological evaluation of pancreatic head cancer patients.

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International consensus statement on robotic hepatectomy surgery in 2018

Cited by 160 publications

References 83 publications

Liver resection and transplantation for intrahepatic cholangiocarcinoma

Liver resection and transplantation for intrahepatic cholangiocarcinoma

A Single-Center Retrospective and Descriptive Study of Hepatobiliary and Pancreatic Surgical Oncology during the COVID-19 Epidemic

Prognostic significance of peritumoral fibrosis after resection of pancreatic head cancer

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