Ann Hepatobiliary Pancreat Surg.  2023 Feb;27(1):6-19. 10.14701/ahbps.22-045.

Procedural outcomes of laparoscopic caudate lobe resection: A systematic review and meta-analysis

Affiliations
  • 1Cardiff Liver Unit, University Hospital of Wales, Cardiff and Vale NHS Trust, Cardiff, United Kingdom
  • 2Department of General Surgery, Glan Clwyd Hospital, Rhyl, United Kingdom
  • 3Department of General Surgery, Royal Glamorgan Hospital, Cwm Taf University Health Board, Pontyclun, United Kingdom
  • 4Undergraduate Department, School of Medicine, Cardiff University, Cardiff, United Kingdom
  • 5Hepatobiliary and Pancreatic Surgery and Liver Transplant Unit, Queen Elizabeth Hospital, Birmingham, United Kingdom
  • 6Department of Hepatobiliary and Pancreatic Surgery, Manchester Royal Infirmary Hospital, Manchester, United Kingdom

Abstract

A systematic review was conducted in compliance with PRISMA statement standards to identify all studies reporting outcomes of laparoscopic resection of benign or malignant lesions located in caudate lobe of liver. Pooled outcome data were calculated using random-effects models. A total of 196 patients from 12 studies were included. Mean operative time, volume of intraoperative blood loss, and length of hospital stay were 225 minutes (95% confidence interval [CI], 181–269 minutes), 134 mL (95% CI, 85–184 mL), and 7 days (95% CI, 5–9 days), respectively. The pooled risk of need for intraoperative transfusion was 2% (95% CI, 0%–5%). It was 3% (95% CI, 1%–6%) for conversion to open surgery, 6% (95% CI, 0%–19%) for need for intra-abdominal drain, 1% (95% CI, 0%–3%) for postoperative mortality, 2% (95% CI, 0%–4%) for biliary leakage, 2% (95% CI, 0%–4%) for intra-abdominal abscess, 1% (95% CI, 0%–4%) for biliary stenosis, 1% (95% CI, 0%–3%) for postoperative bleeding, 1% (95% CI, 0%–4%) for pancreatic fistula, 2% (95% CI, 1%–5%) for pulmonary complications, 1% (95% CI, 0%–4%) for paralytic ileus, and 1% (95% CI, 0%–4%) for need for reoperation. Although the available evidence is limited, the findings of the current study might be utilized for hypothesis synthesis in future studies. They can be used to inform surgeons and patients about estimated risks of perioperative complications until a higher level of evidence is available.

Keyword

Laparoscopy; Caudate lobe; Liver resection; Hepatectomy

Figure

  • Fig. 1 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow chart.

  • Fig. 2 Outcomes of methodological quality assessment of included studies using the Joanna Briggs Institute (JBI) Critical Appraisal tool for case-series.

  • Fig. 3 Forest plots and Doi plots for: (A) need for intraoperative transfusion; (B) conversion to open surgery; (C) need for intra-abdominal drain; (D) postoperative mortality; (E) biliary leakage; (F) intra-abdominal abscess; (G) biliary stenosis; (H) postoperative bleeding; (I) pancreatic fistula; (J) pulmonary complications; (K) paralytic ileus; and (L) need for reoperation.


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