Four-year experience with more than 1000 cases of total laparoscopic liver resection in a single center

Table 1 The demographic data of all 1098 patients

Demographic data	Frequencies	Range/percentage
Sex
Male	655	59.65%
Female	443	40.35%
Age (yr)	50.28 ± 13.01	15-86
Disease
HCC	462	42.08%
ICC	58	5.28%
HCC and ICC mixed carcinoma	5	0.46%
Metastasis	92	8.38%
Hepatolithiasis	59	5.37%
Hemangioma	213	19.40%
FNH and hyperplastic disease	88	8.01%
Parasitic disease	30	2.73%
Living donors	15	1.37%
Liver abscess	11	1.00%
Caroli disease	5	0.46%
Hepatic cyst	6	0.55%
Trauma	2	0.18%
Other benign liver occupancy	52	4.73%

ICC: Intrahepatic cholangiocarcinoma; FNH: Focal nodular hyperplasia; HCC: Hepatocellular carcinoma.

Table 2 Main operation-related data for different years

Index/year	2015 (n = 88)	2016 (n = 279)	2017 (n = 351)	2018 (n = 380)	F/x2	P value
Age (yr)	51.97 ± 11.35	49.34 ± 12.60	49.88 ± 13.05	50.95 ± 13.58	1.415	-
Sex (M/F)	55/34	159/120	203/148	239/141	3.134	-
LLR types
Local resection	2.27% (2/88)	35.13% (98/279)	39.60% (139/351)	36.58% (139/380)	45.306	< 0.01b
Anatomical resection	23.86% (21/88)	8.24% (23/279)	11.40% (40/351)	9.47% (36/380)	18.096	< 0.01b
Right hemi-hepatectomy	14.77% (13/88)	9.32% (26/279)	7.41% (26/351)	5.79% (22/380)	8.903	< 0.05a
Pre-operative ALT (U/L)	36.82 ± 28.17	36.67 ± 20.05	35.71 ± 25.37	43.58 ± 33.39	1.667	-
Pre-operative TBL (umol/L)	14.76 ± 5.81	13.55 ± 5.83	13.51 ± 6.21	14.63 ± 7.78	2.519	-
Inpatient time (d)	12.48 ± 6.23	11.77 ± 6.67	9.53± 5.04	8.03 ± 3.20	37.583	< 0.01b
Post operative inpatient time (d)	7.98 ± 5.00	6.87 ± 4.82	5.39 ± 3.70	4.70 ± 2.22	29.781	< 0.01b
Hospitalization expense (RMB, Yuan)	48708.55 ± 20939.76	47280.53 ± 17249.26	46468.97 ± 35172.25	43016.31 ± 14509.30	2.448	-
Operation time (min)	257.98 ± 114.25	236.85 ± 100.40	203.81 ± 85.83	205.61 ± 99.54	12.596	< 0.01b
Blood loss (mL)	275.65 ± 39.19	245.53 ± 19.10	232.54 ± 12.34	241.84 ± 20.32	0.413	-
Post operative ALT (U/L)	355.19 ± 44.44	288.22 ± 19.17	237.16 ± 10.66	251.93 ± 16.03	5.262	< 0.01b
Post operative TBL (umol/L)	36.07 ± 3.49	27.86 ± 1.01	28.31 ± 0.92	24.61 ± 1.02	7.443	< 0.01b
Mortality of 90 d	2.27% (2/88)	0.36% (1/279)	0 (0/351)	0 (0/380)	14.989	< 0.01b
Complications	13.64% (12/88)	13.98% (39/279)	7.98% (28/351)	5.79% (22/380)	15.621	< 0.01b
Drainage (mL)	133.12 ± 20.44	111.88 ± 7.62	103.10 ± 6.63	82.44 ± 8.27	3.433	< 0.05a
Conversion rate	0 (0/88)	2.15% (6/279)	2.56% (9/351)	1.32% (5/380)	3.427	-

^aP < 0.05.

^bP < 0.01.

ALT: Alanine transaminase; LLR: Laparoscopic liver resection; TBL: Total bilirubin.

Table 3 Characteristics of patients with hepatocellular carcinoma and mixed carcinoma

	Frequencies	Range/percentage
Incision margin (cm)	1.18 ± 1.0	0-20
Liver cirrhosis
Cirrhosis	201	43.04%
Non	266	56.96%
Tumor location
Central	229	49.03%
Marginal	238	50.97%
BCLC stage
0	81	17.34%
A1	245	52.46%
A2	40	8.57%
A3	22	4.71%
A4	14	3.00%
B	48	10.27%
C	17	3.64%
D	0	0
TNM stage
Ia	302	64.66%
Ib	99	21.20%
IIa	43	9.21%
IIb	15	3.21%
IIIa	7	1.50%
IIIb	1	0.21%
IV	0	0
Liver capsule invasion
Positive	156	33.40%
Differentiation	311	66.60%
Well-moderate	275	58.87%
Poor	192	41.13%

BCLC: Barcelona Clinic Liver Cancer; TNM: Tumor-node-metastasis.