{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:07:24Z","timestamp":1790741244645,"version":"4.1.0"},"reference-count":52,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T00:00:00Z","timestamp":1745971200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T00:00:00Z","timestamp":1745971200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Ulm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Laparoscopic liver resection (LLR) for lesions in the posterosuperior segments (PSS) is challenging. Identifying and minimizing risk factors for postoperative morbidity and mortality is crucial. This retrospective cohort study shares initial experiences with LLR of the PSS (VII, VIII, IVa) and wants to identify risk factors for clinically relevant postoperative complications (Clavien\u2013Dindo grade\u2009\u2265\u2009III) in these patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We reviewed our prospective database for all patients who underwent LLR with at least one lesion in the PSS (April 2018\u2013October 2022). Uni- and multivariate analyses were carried out using binary logistic regression analysis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>110 patients underwent LLR of the PSS. Median age was 67\u00a0years (IQR 59\u201376); 62% were male (<jats:italic>n<\/jats:italic>\u2009=\u200968), with a median BMI of 26 (IQR 23\u201330). The most frequent indications for LLR were primary liver cancer (37%) and colorectal liver metastasis (36%). Median operating time was 211\u00a0min (IQR 135\u2013281) with a median blood loss of 460\u00a0mL (IQR 240\u20131200). Postoperative length of stay was 6\u00a0days (IQR 4\u20138). Clinically relevant postoperative complications were present in 20 patients (18%) with a 90-day mortality rate of 5% (<jats:italic>n<\/jats:italic>\u2009=\u20096). Multivariate analyses identified ASA\u2009\u2265\u2009III (OR 3.23 [95%CI 1.03\u201310.09]; <jats:italic>p<\/jats:italic>\u2009=\u20090.043), diabetes (OR 4.31 [95%CI 1.20\u201315.49]; <jats:italic>p<\/jats:italic>\u2009=\u20090.025), and intraoperative transfusion of packed red blood cells (PRBC) (OR 4.80 [95%CI 1.01\u201322.86]; <jats:italic>p<\/jats:italic>\u2009=\u20090.049) as risk factors for Clavien\u2013Dindo grade\u2009\u2265\u2009III complications.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>ASA\u2009\u2265\u2009III status, diabetes, and intraoperative PRBC transfusion are associated with an increased risk of Clavien\u2013Dindo grade\u2009\u2265\u2009III complications in patients undergoing LLR in PSS. Preoperative optimization should include diabetes management, screening for anemia with appropriate supplementation, and comprehensive risk counseling for ASA\u2009\u2265\u2009III patients. Additionally, minimizing intraoperative PRBC transfusion should remain a key perioperative goal.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00464-025-11674-9","type":"journal-article","created":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T03:52:34Z","timestamp":1746071554000},"page":"3691-3701","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["What matters in laparoscopic hepatectomy for lesions located in posterosuperior segments? Initial experiences and analysis of risk factors for postoperative complications: a retrospective cohort study"],"prefix":"10.1007","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2280-0271","authenticated-orcid":false,"given":"Patrick","family":"T\u00e9oule","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niccolo","family":"Dunker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"G\u00f6lz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Rasbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Reissfelder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emrullah","family":"Birgin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuh N.","family":"Rahbari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,30]]},"reference":[{"key":"11674_CR1","doi-asserted-by":"publisher","first-page":"886","DOI":"10.1007\/s00464-004-2044-3","volume":"19","author":"JL Dulucq","year":"2005","unstructured":"Dulucq JL, Wintringer P, Stabilini C, Berticelli J, Mahajna A (2005) Laparoscopic liver resections: a single center experience. 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