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Surgical Management of Hepatic Benign Disease: Have the Number of Liver Resections Increased in the Era of Minimally Invasive Approach? Analysis from the I Go MILS (Italian Group of Minimally Invasive Liver Surgery) Registry

  • Francesco ArditoEmail author
  • Luca Aldrighetti
  • Alfredo Guglielmi
  • Elio Jovine
  • Umberto Cillo
  • Alessandro Ferrero
  • Luciano De Carlis
  • Giulio Belli
  • Raffaele Dalla Valle
  • Abdallah Slim
  • Vincenzo Mazzaferro
  • Giuseppe Navarra
  • Giuseppe M. Ettorre
  • Fulvio Calise
  • Antonio D. Pinna
  • Felice Giuliante
  • Italian Group of Minimally Invasive Liver Surgery (I Go MILS)
Original Article
  • 26 Downloads

Abstract

Background

Increased expertise with minimally invasive liver surgery (MILS) could cause an unjustified extension of indications to resect liver benign disease (BD). The aim of this study was to evaluate the operative risk of MILS for BD and if implementation and diffusion of MILS have widened indications for BD resection.

Methods

A prospective study including centers with > 6 MILS for BD, enrolled in the I Go MILS registry from January 2015 to October 2016. Cysts fenestrations were excluded.

Results

Eight hundred eighteen MILS were performed in 15 centers. One hundred seventy-three of these (21.1%) were for BD: conversion rate was 6.9%, postoperative mortality and morbidity rates were 0 and 13.9%. During the same period, 3713 liver resections (open + MILS) were performed and 407 (11.0%) were for BD. A time-trend analysis showed that the total number of MILS and the number of MILS for malignant disease significantly increased, but this increasing trend was not documented for the number of MILS for BD, which remained stable during the study period of time. This trend was confirmed for the overall rate of resected BD (open + MILS) that remained stable.

Discussion

BD represents a valid indication for MILS. For BD, 21.1% of MILS was performed, rate significantly lower than that previously reported in Italy. Although an evident growth of the use of MILS was observed during the time period analysis in Italy, this trend did not correspond to an increased number of MILS for BD, and the overall rate of resected BD was comparable to that reported in previous large open series.

Keywords

Minimally invasive liver surgery Laparoscopic liver resection Benign liver disease Benign liver tumors Operative risk Indications for resection 

Notes

Author Contributions

Francesco Ardito: Substantial contributions to the conception and design of the work; acquisition, analysis, and interpretation of data for the work; drafting the work and revising it critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Luca Aldrighetti: Substantial contributions to the conception and design of the work; revising the work critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Alfredo Guglielmi: Substantial contributions to the conception and design of the work; revising the work critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Elio Jovine: Substantial contributions to the conception and design of the work; revising the work critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Umberto Cillo: Substantial contributions to the conception and design of the work; revising the work critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Alessandro Ferrero: Substantial contributions to the conception and design of the work; revising the work critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Luciano De Carlis: Substantial contributions to the conception and design of the work; revising the work critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Giulio Belli: Substantial contributions to the conception and design of the work; revising the work critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Raffaele Dalla Valle: Substantial contributions to the conception and design of the work; revising the work critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Abdallah Slim: Substantial contributions to the conception and design of the work; revising the work critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Vincenzo Mazzaferro: Substantial contributions to the conception and design of the work; revising the work critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Giuseppe Navarra: Substantial contributions to the conception and design of the work; revising the work critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Giuseppe M. Ettorre: Substantial contributions to the conception and design of the work; revising the work critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Fulvio Calise: Substantial contributions to the conception and design of the work; revising the work critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Antonio D. Pinna: Substantial contributions to the conception and design of the work; revising the work critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Felice Giuliante: Substantial contributions to the conception and design of the work; revising the work critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Collaborators (I Go MILS Group)

Massimiliano Casati: acquisition, analysis, and interpretation of data for the work; revising the work critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Matteo Cescon: acquisition, analysis, and interpretation of data for the work; revising the work critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Marco Colasanti: acquisition, analysis, and interpretation of data for the work; revising the work critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Stefano Di Sandro: acquisition, analysis, and interpretation of data for the work; revising the work critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Antonio Giuliani: acquisition, analysis, and interpretation of data for the work; revising the work critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Enrico Gringeri: acquisition, analysis, and interpretation of data for the work; revising the work critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Francesca Ratti: acquisition, analysis, and interpretation of data for the work; revising the work critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Nadia Russolillo: acquisition, analysis, and interpretation of data for the work; revising the work critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Andrea Ruzzenente: acquisition, analysis, and interpretation of data for the work; revising the work critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Carlo Sposito: acquisition, analysis, and interpretation of data for the work; revising the work critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Matteo Zanello: acquisition, analysis, and interpretation of data for the work; revising the work critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Compliance with Ethical Standards

Conflicts of Interest

The authors declare that they have no conflict of interest.

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Copyright information

© The Society for Surgery of the Alimentary Tract 2019

Authors and Affiliations

  • Francesco Ardito
    • 1
    Email author
  • Luca Aldrighetti
    • 2
  • Alfredo Guglielmi
    • 3
  • Elio Jovine
    • 4
  • Umberto Cillo
    • 5
  • Alessandro Ferrero
    • 6
  • Luciano De Carlis
    • 7
  • Giulio Belli
    • 8
  • Raffaele Dalla Valle
    • 9
  • Abdallah Slim
    • 10
  • Vincenzo Mazzaferro
    • 11
  • Giuseppe Navarra
    • 12
  • Giuseppe M. Ettorre
    • 13
  • Fulvio Calise
    • 14
  • Antonio D. Pinna
    • 15
  • Felice Giuliante
    • 1
  • Italian Group of Minimally Invasive Liver Surgery (I Go MILS)
  1. 1.Hepatobiliary Surgery Unit, Fondazione Policlinico Universitario A. Gemelli IRCCSCatholic University of the Sacred HeartRomeItaly
  2. 2.Hepatobiliary Surgery DivisionIRCCS San Raffaele HospitalMilanItaly
  3. 3.General and Hepatobiliary SurgeryUniversity of VeronaVeronaItaly
  4. 4.Department of SurgeryMaggiore HospitalBolognaItaly
  5. 5.Department of Surgery, Oncology and GastroenterologyUniversity of PaduaPaduaItaly
  6. 6.Department of General and Oncological SurgeryMauriziano HospitalTurinItaly
  7. 7.Department of General Surgery and TransplantationNiguarda Ca’ Granda HospitalMilanItaly
  8. 8.Department of General and HPB SurgeryLoreto Nuovo HospitalNaplesItaly
  9. 9.Department of SurgeryUniversity of ParmaParmaItaly
  10. 10.General Surgery UnitVimercate HospitalVimercateItaly
  11. 11.General Surgery and Liver Transplantation Unit, Fondazione IRCCS Istituto Nazionale Tumori di Milano (National Cancer Institute)University of MilanMilanItaly
  12. 12.Department of Human Pathology of Adult and Evolutive AgeUniversity Hospital of MessinaMessinaItaly
  13. 13.Division of General Surgery and Liver TransplantationS. Camillo HospitalRomeItaly
  14. 14.Centre of Hepatobiliarypancreatic SurgeryPineta Grande HospitalCastel VolturnoItaly
  15. 15.Department of Surgery and Transplantation, Sant’Orsola-Malpighi HospitalUniversity of BolognaBolognaItaly

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