Background:With the rapid development of robotic surgery,especially for the abdominal surgery,robotic pancreatic surgery(RPS)has been applied increasingly around the world.However,evidence-based guidelines regarding i...Background:With the rapid development of robotic surgery,especially for the abdominal surgery,robotic pancreatic surgery(RPS)has been applied increasingly around the world.However,evidence-based guidelines regarding its application,safety,and efficacy are still lacking.To harvest robust evidence and comprehensive clinical practice,this study aims to develop international guidelines on the use of RPS.Methods:World Health Organization(WHO)Handbook for Guideline Development,GRADE Grid method,Delphi vote,and the AGREE-II instrument were used to establish the Guideline Steering Group,Guideline Development Group,and Guideline Secretary Group,formulate 19 clinical questions,develop the recommendations,and draft the guidelines.Three online meetings were held on 04/12/2020,30/11/2021,and 25/01/2022 to vote on the recommendations and get advice and suggestions from all involved experts.All the experts focusing on minimally invasive surgery from America,Europe and Oceania made great contributions to this consensus guideline.Results:After a systematic literature review 176 studies were included,19 questions were addressed and 14 recommendations were developed through the expert assessment and comprehensive judgment of the quality and credibility of the evidence.Conclusions:The international RPS guidelines can guide current practice for surgeons,patients,medical societies,hospital administrators,and related social communities.Further randomized trials are required to determine the added value of RPS as compared to open and laparoscopic surgery.展开更多
Currently,the terminology for liver anatomy and resection was based on the updates of the Brisbane 2000 system(1).In this setting,Couinaud’s anatomical description serves as the backbone for the classification of res...Currently,the terminology for liver anatomy and resection was based on the updates of the Brisbane 2000 system(1).In this setting,Couinaud’s anatomical description serves as the backbone for the classification of resection(2).Based on this classification,an anatomic liver resection was defined as the complete removal of the liver parenchyma confined within the responsible portal territory.Anatomical subsegmentectomy is defined as the removal of the liver parenchyma within the portal territory of less than a Couinaud’s segment.These are also defined as cone units,and their areas can be intraoperatively assessed by using ischemic demarcation,indocyanine green(ICG)staining,or both.展开更多
We read with great interest the national retrospective multicenter observational study recently published by Chiche and collaborators(1)aiming to review liver transplants related to iatrogenic bile duct injury(BDI)dur...We read with great interest the national retrospective multicenter observational study recently published by Chiche and collaborators(1)aiming to review liver transplants related to iatrogenic bile duct injury(BDI)during cholecystectomy and the risk factors for adverse outcomes in order to improve management of BDI.In this study,all liver transplantation(LT)patients between 1994 and 2017 for BDI during cholecystectomy were included.Thirty patients were included in 11 French LT centers representing 0.13%of LT indications over this period.展开更多
文摘Background:With the rapid development of robotic surgery,especially for the abdominal surgery,robotic pancreatic surgery(RPS)has been applied increasingly around the world.However,evidence-based guidelines regarding its application,safety,and efficacy are still lacking.To harvest robust evidence and comprehensive clinical practice,this study aims to develop international guidelines on the use of RPS.Methods:World Health Organization(WHO)Handbook for Guideline Development,GRADE Grid method,Delphi vote,and the AGREE-II instrument were used to establish the Guideline Steering Group,Guideline Development Group,and Guideline Secretary Group,formulate 19 clinical questions,develop the recommendations,and draft the guidelines.Three online meetings were held on 04/12/2020,30/11/2021,and 25/01/2022 to vote on the recommendations and get advice and suggestions from all involved experts.All the experts focusing on minimally invasive surgery from America,Europe and Oceania made great contributions to this consensus guideline.Results:After a systematic literature review 176 studies were included,19 questions were addressed and 14 recommendations were developed through the expert assessment and comprehensive judgment of the quality and credibility of the evidence.Conclusions:The international RPS guidelines can guide current practice for surgeons,patients,medical societies,hospital administrators,and related social communities.Further randomized trials are required to determine the added value of RPS as compared to open and laparoscopic surgery.
文摘Currently,the terminology for liver anatomy and resection was based on the updates of the Brisbane 2000 system(1).In this setting,Couinaud’s anatomical description serves as the backbone for the classification of resection(2).Based on this classification,an anatomic liver resection was defined as the complete removal of the liver parenchyma confined within the responsible portal territory.Anatomical subsegmentectomy is defined as the removal of the liver parenchyma within the portal territory of less than a Couinaud’s segment.These are also defined as cone units,and their areas can be intraoperatively assessed by using ischemic demarcation,indocyanine green(ICG)staining,or both.
文摘We read with great interest the national retrospective multicenter observational study recently published by Chiche and collaborators(1)aiming to review liver transplants related to iatrogenic bile duct injury(BDI)during cholecystectomy and the risk factors for adverse outcomes in order to improve management of BDI.In this study,all liver transplantation(LT)patients between 1994 and 2017 for BDI during cholecystectomy were included.Thirty patients were included in 11 French LT centers representing 0.13%of LT indications over this period.
