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Laparoscopic liver resection can be performed safely without intraoperative drain placement

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Abstract

Background

Laparoscopic liver resection (LLR) has become a standardized procedure with advances in surgical techniques and perioperative management in the last decade; however, the necessity of routine drain placement in LLR has not been fully investigated. This study aimed to evaluate the need for intraoperative drain placement (IDP) in LLR.

Methods

A total of 607 patients who underwent LLR for liver tumor at our institution between January 2015 and August 2021 were studied. Clinicopathological data, including intraoperative factors and postoperative outcomes, were compared between patients with and without IDP before and after propensity score matching. Variables shown to be different between the two groups were used for matching. Then, risk analysis for additional drainage procedure after surgery was performed in the original and matched cohorts.

Results

Of the 607 patients, 4 (0.7%) and 14 (2.3%) developed incisional and organ/space surgical site infections, respectively, and 9 (1.5%) required additional drainage procedure after surgery. Ninety-three patients (15.3%) underwent IDP. The incidence and severity of postoperative complications were similar between patients with and without IDP in both the original and matched cohorts. In the matched cohort, simultaneous colectomy (odds ratio, 14.051, 95% confidence interval, 1.103–178.987; P = 0.042), rather than IDP (odds ratio, 1.836, 95% confidence interval, 0.157–21.509; P = 0.629), was independently associated with the risk of additional drainage procedure after surgery.

Conclusions

This study demonstrated that LLR could be performed safely without IDP.

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Acknowledgements

The authors thank Ryo Sadachi (Department of Biostatistics, National Cancer Center) for his support of statistical analysis.

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Authors and Affiliations

  1. Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital East, 6-5-1, Kashiwa-no-ha, Kashiwa, Chiba, 277-8577, Japan

    Motokazu Sugimoto, Naoto Gotohda, Masashi Kudo, Shin Kobayashi, Shinichiro Takahashi & Masaru Konishi

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  1. Motokazu Sugimoto
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  2. Naoto Gotohda
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  3. Masashi Kudo
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  4. Shin Kobayashi
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  5. Shinichiro Takahashi
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  6. Masaru Konishi
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Corresponding author

Correspondence to Motokazu Sugimoto.

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Disclosures

Drs. Motokazu Sugimoto, Naoto Gotohda, Masashi Kudo, Shin Kobayashi, Shinichiro Takahashi, and Masaru Konishi have no conflicts of interest or financial ties to disclose.

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Sugimoto, M., Gotohda, N., Kudo, M. et al. Laparoscopic liver resection can be performed safely without intraoperative drain placement. Surg Endosc 36, 9019–9031 (2022). https://doi.org/10.1007/s00464-022-09364-x

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  • DOI: https://doi.org/10.1007/s00464-022-09364-x

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