Implementation and outcome of minor and major minimally invasive liver surgery in the Netherlands

Marcel J. van der Poel, Robert S. Fichtinger, Marc Bemelmans, Koop Bosscha, Andries E. Braat, Marieke T. de Boer, Cornelis H. C. Dejong, Pascal G. Doornebosch, Werner A. Draaisma, Michael F. Gerhards, Paul D. Gobardhan, Burak Gorgec, Jeroen Hagendoorn, Geert Kazemier, Joost Klaase, Wouter K. G. Leclercq, Mike S. Liem, Daan J. Lips, Hendrik A. Marsman, J. Sven D. MieogQuintus I. Molenaar, Vincent B. Nieuwenhuijs, Carolijn L. Nota, Gijs A. Patijn, Arjen M. Rijken, Gerrit D. Slooter, Martijn W. J. Stommel, Rutger-Jan Swijnenburg, Pieter J. Tanis, Wouter W. te Riele, T. rkan Terkivatan, Petrousjka M. van den Tol, Peter B. van den Boezem, Joost A. van der Hoeven, Maarten Vermaas, Moh'd Abu Hilal, Ronald M. van Dam, Marc G. Besselink, Babs Zonderhuis, Inne B. Rinkes, Christiaan Hoff, Steven Oosterling

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: While most of the evidence on minimally invasive liver surgery (MILS) is derived from expert centers, nationwide outcomes remain underreported. This study aimed to evaluate the implementation and outcome of MILS on a nationwide scale. Methods: Electronic patient files were reviewed in all Dutch liver surgery centers and all patients undergoing MILS between 2011 and 2016 were selected. Operative outcomes were stratified based on extent of the resection and annual MILS volume. Results: Overall, 6951 liver resections were included, with a median annual volume of 50 resections per center. The overall use of MILS was 13% (n = 916), which varied from 3% to 36% (P < 0.001) between centers. The nationwide use of MILS increased from 6% in 2011 to 23% in 2016 (P < 0.001). Outcomes of minor MILS were comparable with international studies (conversion 0–13%, mortality <1%). In centers which performed ≥20 MILS annually, major MILS was associated with less conversions (14 (11%) versus 41 (30%), P < 0.001), shorter operating time (184 (117–239) versus 200 (139–308) minutes, P = 0.010), and less overall complications (37 (30%) versus 58 (42%), P = 0.040). Conclusion: The nationwide use of MILS is increasing, although large variation remains between centers. Outcomes of major MILS are better in centers with higher volumes.
Original languageEnglish
Pages (from-to)1734-1743
JournalHPB
Volume21
Issue number12
DOIs
Publication statusPublished - Dec 2019

Cite this

van der Poel, M. J., Fichtinger, R. S., Bemelmans, M., Bosscha, K., Braat, A. E., de Boer, M. T., ... Oosterling, S. (2019). Implementation and outcome of minor and major minimally invasive liver surgery in the Netherlands. HPB, 21(12), 1734-1743. https://doi.org/10.1016/j.hpb.2019.05.002