Minimally Invasive HPB and Oncologic Surgery

On this episode of the SO Files, Brad and Linda discuss minimally invasive hepatobiliary surgical oncology, focusing specifically on MIS pancreatic and liver surgery. The SO Files welcome special guest, Dr. Chet Hammill, Associate Professor of Surgery in the Hepatobiliary and GI Surgical Section at Wash U, Barnes Jewish Hospital.

Papers Discussed

Minimally Invasive Versus Open Pancreaticoduodenectomy: A Propensity-Matched Study From a National Cohort of Patients.
Nassour I, Wang SC, Christie A, Augustine MM, Porembka MR, Yopp AC, Choti MA, Mansour JC, Xie XJ, Polanco PM, Minter RM.
A propensity matched analysis of MIS vs. open pancreaticoduodenectomy, using the pancreas-targeted ACS NSQIP database. Minimally invasive whipples had a similar morbidity/mortality to open whipples. A decreased length of stay in the MIS group was partially offset by an increased readmission rate, and SSI was only decreased when removing those MIS whipples without conversion to open or open assist.

Laparoscopic Versus Open Resection for Colorectal Liver Metastases: The OSLO-COMET Randomized Controlled Trial.

Fretland ÅA, Dagenborg VJ, Bjørnelv GMW, Kazaryan AM, Kristiansen R, Fagerland MW, Hausken J, Tønnessen TI, Abildgaard A, Barkhatov L, Yaqub S, Røsok BI, Bjørnbeth BA, Andersen MH, Flatmark K, Aas E, Edwin B; Oslo-CoMet study group.

A randomized controlled trial of lap vs open surgery for colorectal liver mets that could be resected with a parenchyma sparing resection. Lap liver resection had equivalent R0 rate to open, was cost effective, and had fewer postoperative complications.