{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T03:07:52Z","timestamp":1740107272724,"version":"3.37.3"},"reference-count":35,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T00:00:00Z","timestamp":1664150400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T00:00:00Z","timestamp":1664150400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T00:00:00Z","timestamp":1664150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Minimally invasive liver surgery (MILS) has been progressively adopted on a nationwide scale. The aim of this study is to investigate MILS implementation in a high\u2010volume Dutch hepato\u2010pancreato\u2010biliary and transplant center, which is considered a moderate to low\u2010volume center from a European standpoint.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients who underwent MILS at Erasmus Medical Center between April 2010 and December 2021 were retrospectively reviewed. Patients\u2019 surgical outcomes were compared after stratification according to resections\u2019 difficulty and liver cirrhosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 212 cases were included. Major liver resections were performed in 24 patients (11%), while minor resections were performed in 188 patients (89%). Among those, 177 (94%) resections were classified as technically minor and 11 (6%) as technically major. Major morbidity was reported in 14\/177 patients (8%) after technically minor resections and in 3\/24 patients (13%) after major resections. Anatomically and technically major resections had higher intraoperative blood losses (425 (0\u20132100) vs. 240 (50\u2013110) vs. 100 (0\u20132400) mL; <jats:italic>p<\/jats:italic>\u2010value\u2009&lt;\u20090.001) and longer hospital stay (6 (3\u201325) vs. 5 (2\u20139) vs. 3 (1\u201344); <jats:italic>p<\/jats:italic>\u2010value\u2009&lt;\u20090.001) when compared with the technically minor counterpart. Perioperative outcomes were similar when comparing cirrhotic MILS with the non\u2010cirrhotic cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>MILS program implementation can lead to encouraging surgical outcomes even in low\u2010 to moderate\u2010volume centers. Although low procedural volume might be predictive of impaired outcomes, long\u2010standing experience in the HPB and liver transplant field could mitigate low\u2010case volume effects on surgical outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-022-06754-z","type":"journal-article","created":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T13:04:00Z","timestamp":1664197440000},"page":"3090-3099","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Minimally Invasive Liver Surgery: A Snapshot from a Major Dutch HPB and Transplant Center"],"prefix":"10.1002","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2069-6485","authenticated-orcid":false,"given":"Rebecca","family":"Marino","sequence":"first","affiliation":[{"name":"Hepatobiliary Surgery Division IRCCS San Raffaele Hospital Via Olgettina 60 20132 Milan Italy"},{"name":"Department of Surgery, Division of HPB &amp; Transplant Surgery University Medical Centre Rotterdam Dr. Molewaterplein 40, Erasmus MC 3015 GD Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pim B.","family":"Olthof","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of HPB &amp; Transplant Surgery University Medical Centre Rotterdam Dr. Molewaterplein 40, Erasmus MC 3015 GD Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong J.","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of HPB &amp; Transplant Surgery University Medical Centre Rotterdam Dr. Molewaterplein 40, Erasmus MC 3015 GD Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khe T. 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