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- Title
The learning curve in pure laparoscopic donor right hepatectomy: a cumulative sum analysis.
- Authors
Hong, Suk Kyun; Suh, Kyung-Suk; Yoon, Kyung Chul; Lee, Jeong-Moo; Cho, Jae-Hyung; Yi, Nam-Joon; Lee, Kwang-Woong
- Abstract
<bold>Background: </bold>Although the use of pure laparoscopic donor hepatectomy (PLDH) is increasingly common, it remains limited to a few experienced centers and no data on the learning curve are currently available. The aim of this study is to evaluate the learning curve associated with the use of pure laparoscopic donor right hepatectomy (PLDRH).<bold>Methods: </bold>Data from donors undergoing PLDRH performed by a single surgeon between November 2015 and October 2017 were retrospectively reviewed. The learning curve was evaluated using the cumulative sum (CUSUM) method based on duration of surgery.<bold>Results: </bold>Of 100 donors evaluated, none required transfusion or conversion to open hepatectomy and no irreversible disability or mortality was reported. The mean operative time was 320.7 ± 51.8 min, and all grafts were successfully transplanted. The CUSUM analysis demonstrated a learning curve of approximately 60 cases of PLDRH. Estimated total liver volume > 1400 cm3 and double portal vein orifices were seen to be risk factors for longer surgery time. Having adjusted for case mix with these factors, the risk-adjusted CUSUM analysis demonstrated a learning curve of 65-70 cases of PLDRH.<bold>Conclusions: </bold>In conclusion, PLDRH is a feasible and safe procedure with a learning curve of 65-70 cases.
- Subjects
PREOPERATIVE risk factors; HEPATECTOMY; ENDOSCOPIC surgery; PORTAL vein; SURGICAL robots
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2019, Vol 33, Issue 11, p3741
- ISSN
1866-6817
- Publication type
journal article
- DOI
10.1007/s00464-019-06668-3