{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T01:54:40Z","timestamp":1792374880553,"version":"4.4.0"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2020,1,10]],"date-time":"2020-01-10T00:00:00Z","timestamp":1578614400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,5,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>This study aimed to assess the best achievable outcomes in laparoscopic liver resection (LLR) after risk adjustment based on surgical technical difficulty using a national registry.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>LLRs registered in the Italian Group of Minimally Invasive Liver Surgery registry from November 2014 to March 2018 were considered. Benchmarks were calculated according to the Achievable Benchmark of Care (ABC\u2122). LLRs at each centre were divided into three clusters (groups I, II and III) based on the Kawaguchi classification. ABCs for overall and major morbidity were calculated in each cluster. Multivariable analysis was used to identify independent risk factors for overall and major morbidity. Significant variables were used in further risk adjustment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 1752 of 2263 patients fulfilled the inclusion criteria: 1096 (62\u00b76 per cent) in group I, 435 (24\u00b78 per cent) in group II and 221 (12\u00b76 per cent) in group III. The ABCs for overall morbidity (7\u00b78, 14\u00b72 and 26\u00b74 per cent for grades I, II and II respectively) and major morbidity (1\u00b74, 2\u00b72 and 5\u00b77 per cent) increased with the difficulty of LLR. Multivariable analysis showed an increased risk of overall morbidity associated with multiple LLRs (odds ratio (OR) 1\u00b735), simultaneous intestinal resection (OR 3\u00b776) and cirrhosis (OR 1\u00b783), and an increased risk of major morbidity with intestinal resection (OR 4\u00b761). ABCs for overall and major morbidity were 14\u00b74 and 3\u00b72 per cent respectively for multiple LLRs, 30 and 11\u00b71 per cent for intestinal resection, and 14\u00b79 and 4\u00b78 per cent for cirrhosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Overall morbidity benchmarks for LLR ranged from 7\u00b78 to 26\u00b74 per cent, and those for major morbidity from 1\u00b74 to 5\u00b77 per cent, depending on complexity. Benchmark values should be adjusted according to multiple LLRs or simultaneous intestinal resection and cirrhosis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.11404","type":"journal-article","created":{"date-parts":[[2020,1,11]],"date-time":"2020-01-11T07:45:48Z","timestamp":1578728748000},"page":"845-853","source":"Crossref","is-referenced-by-count":46,"title":["Risk-adjusted benchmarks in laparoscopic liver surgery in a national cohort"],"prefix":"10.1093","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0627-186X","authenticated-orcid":false,"given":"N","family":"Russolillo","sequence":"first","affiliation":[{"name":"Department of General and Oncological Surgery, Mauriziano Hospital , Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7729-2468","authenticated-orcid":false,"given":"L","family":"Aldrighetti","sequence":"additional","affiliation":[{"name":"Hepatobiliary Surgery, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Hospital , Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U","family":"Cillo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Oncology and Gastroenterology, University of Padua , Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Guglielmi","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery, G. 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