Laparoscopic Liver Resection: A South American Experience with 2887 Cases
Juan Pekolj, R. Clariá Sánchez, J. Salceda, Rafael Maurette, Pablo Barros Schelotto, Luis E. Pierini, E. Cánepa, Mariano Moro, Gustavo Stork, N. Resio, J. Neffa, Lucas Mc Cormack, Emilio Quiñonez, G. Raffin, Lucio Ricardo Obeide, Diego L. Fernández, G. Pfaffen, Christina Salas, M. Linzey, G Schmidt, S. Salvans Ruiz, Fernando A. Alvarez, J. Buffaliza, Rodrigo Maroni, O Campi, Christian Bertona, Martín de Santibañes, Osvaldo Mazza, M.B. de Oliveira, Alessandro Landskron Diniz, M. Enne de Oliveira, Marcel Autran C. Machado, Antônio Nocchi Kalil, Rodrigo Pinto, Adrillenne Pinheiro Silva Rezende, Eduardo J.B. Ramos, Antônio Talvane Torres de Oliveira, Orlando Jorge Martins Torres, Nicolás Jarufe Cassis, E. Buckel, Rubén Torres, Javier Chapochnick, M. Sanhueza García, César Muñoz, Gabriela Dabus Sousa Castro, H. Losada, F. Vergara Suárez, Óscar Guevara, Diego F. Dávila, O Palacios, Ángel Martín Jiménez, Luis Poggi, Vinícius Penna Torres, Gilton Marques Fonseca, Jaime Arthur Pirola Krüger, Fabrício Ferreira Coelho, Louis Russo, Paulo Herman
Abstract
BACKGROUND: Laparoscopic liver resections (LLR) have been increasingly performed in recent years. Most of the available evidence, however, comes from specialized centers in Asia, Europe and USA. Data from South America are limited and based on single-center experiences. To date, no multicenter studies evaluated the results of LLR in South America. The aim of this study was to evaluate the experience and results with LLR in South American centers. METHODS: From February to November 2019, a survey about LLR was conducted in 61 hepatobiliary centers in South America, composed by 20 questions concerning demographic characteristics, surgical data, and perioperative results. RESULTS: Fifty-one (83.6%) centers from seven different countries answered the survey. A total of 2887 LLR were performed, as follows: Argentina (928), Brazil (1326), Chile (322), Colombia (210), Paraguay (9), Peru (75), and Uruguay (8). The first program began in 1997; however, the majority (60.7%) started after 2010. The percentage of LLR over open resections was 28.4% (4.4-84%). Of the total, 76.5% were minor hepatectomies and 23.5% major, including 266 right hepatectomies and 343 left hepatectomies. The conversion rate was 9.7%, overall morbidity 13%, and mortality 0.7%. CONCLUSIONS: This is the largest study assessing the dissemination and results of LLR in South America. It showed an increasing number of centers performing LLR with the promising perioperative results, aligned with other worldwide excellence centers.