López-Ben, S. (Santiago)

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    Robotic versus laparoscopic liver resection for huge (≥10 cm) liver tumors: an international multicenter propensity-score matched cohort study of 799 cases
    (2023) Goh, B.K.P. (Brian K. P.); Park, J.O. (James O.); Sutcliffe, R.P. (Robert P.); Kingham, T.P. (T. Peter); Wakabayashi, G. (Go); Herman, P. (Paulo); D'Hondt, M. (Mathieu); Lee, J.H. (Jae Hoon); Rotellar, F. (Fernando); Chiow, A.K.H. (Adrian K. H.); Cipriani, F. (Federica); Giuliante, F. (Felice); Fuks, D. (David); Aghayan, D.L. (Davit L.); Choi, G. (Gi-Hong); Troisi, R.I. (Roberto I.); Mejía, A. (Alejandro); Cheung, T.T. (Tan To); Di-Benedetto, F. (Fabrizio); Cherqui, D. (Daniel); Tang, C. N. (Chung-Ngai); Edwin, B. (Bjorn); Efanov, M. (Mikhail); Robles-Campos, R. (Ricardo); Scatton, O. (Oliver); Wang, X. (Xiaoying); Chen, K. (KuoHsin); Ferrero, A. (Alessandro); Abu-Hilal, M. (Mohammed); Chong, C.C.N (Charing C. N.); Fondevila, C. (Constantino); Choi, S.H. (Sung Hoon); López-Ben, S. (Santiago); Aldrighetti, L. (Luca); Marino, M.V. (Marco V.); Ruzzenente, A. (Andrea); Sucandy, I. (Iswanto); Han, H.S. (Ho-Seong); Liu, R. (Rong); Pratschke, J. (J.); Syn, N.L. (Nicholas L.); Mazzaferro, V. (Vicenzo); Sugioka, A. (Atsushi); Gastaca, M. (Mikel); Long, T.C.D. (Tran Cong Duy)
    Background: The use of laparoscopic (LLR) and robotic liver resections (RLR) has been safely performed in many institutions for liver tumours. A large scale international multicenter study would provide stronger evidence and insight into application of these techniques for huge liver tumours >_10 cm. Methods: This was a retrospective review of 971 patients who underwent LLR and RLR for huge (>_10 cm) tumors at 42 international centers between 2002-2020. Results: One hundred RLR and 699 LLR which met study criteria were included. The comparison between the 2 approaches for patients with huge tumors were performed using 1:3 propensity-score matching (PSM) (73 vs. 219). Before PSM, LLR was associated with significantly increased frequency of previous abdominal surgery, malignant pathology, liver cirrhosis and increased median blood. After PSM, RLR and LLR was associated with no significant difference in key perioperative outcomes including media operation time (242 vs. 290 min, P=0.286), transfusion rate rate (19.2% vs. 16.9%, P=0.652), median blood loss (200 vs. 300 mL, P=0.694), open conversion rate (8.2% vs. 11.0%, P=0.519), morbidity (28.8% vs. 21.9%, P=0.221), major morbidity (4.1% vs. 9.6%, P=0.152), mortality and postoperative length of stay (6 vs. 6 days, P=0.435). Conclusions: RLR and LLR can be performed safely for selected patients with huge liver tumours with excellent outcomes. There was no significant difference in perioperative outcomes after RLR or LLR.
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    Outcomes after distal pancreatectomy with celiac axis resection for pancreatic cancer: a Pan-European retrospective cohort study
    (Springer Science, 2018) Karayiannakis, A. (Anastasios); Adham, M. (Mustapha); Roeyen, G. (Geert); Darnis, B. (Benjamin); Grützmann, R. (Robert); Sturesson, C. (Christian); Albiol-Quer, T. (Teresa); Boggi, U. (Ugo); Popescu, I. (Irinel); Bassi, C. (Claudio); Mabrut, J.Y. (Jean-Yves); Sauvanet, A. (Alain); Hilst, J. (Jony) van; Salvia, R. (Roberto); Ivanecz, A. (Arpad); Pardo, F. (Fernando); Dumitrascu, T. (Traian); Busch, O. (Olivier R.); Lombardo, C. (Carlo); Lesurtel, M. (Mickael); Fusai, G.K. (Giuseppe K.); Besselink, M.G. (Marc G.); De-Pastena, M. (Matteo); Berrevoet, F. (Frederik); Del-Chiaro, M. (Marco); Klompmaker, S. (Sjors); Gerritsen, S. (Sarah L.); Dalla-Valle, R. (Raffaele); Perinel, J. (Julie); Prasad, R. (Raj); Friess, H. (Helmut); Kleeff, J. (Jorg); Cesaretti, M. (Manuela); López-Ben, S. (Santiago); Niesen, W. (Willem); Labori, K.J. (Knut J.); Diener, M.K. (Markus K.)
    Background: Western multicenter studies on distal pancreatectomy with celiac axis resection (DP-CAR), also known as the Appleby procedure, for locally advanced pancreatic cancer are lacking. We aimed to study overall survival, morbidity, mortality and the impact of preoperative hepatic artery embolization (PHAE). Methods: Retrospective cohort study within the European-African Hepato-Pancreato-Biliary-Association, on DP-CAR between 1-1-2000 and 6-1-2016. Primary endpoint was overall survival. Secondary endpoints were radicality (R0-resection), 90-day mortality, major morbidity, and pancreatic fistulae (grade B/C). Results: We included 68 patients from 20 hospitals in 12 countries. Postoperatively, 53% of patients had R0-resection, 25% major morbidity, 21% an ISGPS grade B/C pancreatic fistula, and 16% mortality. In total, 82% received (neo-)adjuvant chemotherapy and median overall survival in 62 patients with pancreatic ductal adenocarcinoma patients was 18 months (CI 10-37). We observed no impact of PHAE on ischemic complications. Conclusions: DP-CAR combined with chemotherapy for locally advanced pancreatic cancer is associated with acceptable overall survival. The 90-day mortality is too high and should be reduced. Future studies should investigate to what extent increasing surgical volume or better patient selection can improve outcomes.