A Retrospective, Single-Centre Study on the Learning Curve for Liver Tumor Open Resection in Patients with Hepatocellular Cancers and Intrahepatic Cholagangiocarcinomas

Bartlomiej Banas, Piotr Kolodziejczyk, Aleksandra Czerw, Tomasz Banas, Artur Kotwas and Piotr Richter
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Bartlomiej Banas: First Department of Surgery, Jagiellonian University Medical College, 30-688 Krakow, Poland
Piotr Kolodziejczyk: First Department of Surgery, Jagiellonian University Medical College, 30-688 Krakow, Poland
Aleksandra Czerw: Department of Health Economics and Medical Law, Medical University of Warsaw, 02-091 Warsaw, Poland
Tomasz Banas: Department of Gynaecology and Oncology, Jagiellonian University Medical College, 31-501 Krakow, Poland
Artur Kotwas: Sub-Department of Social Medicine and Public Health, Department of Social Medicine, Pomeranian Medical University, 71-210 Szczecin, Poland
Piotr Richter: First Department of Surgery, Jagiellonian University Medical College, 30-688 Krakow, Poland

IJERPH, 2022, vol. 19, issue 8, 1-8

Abstract: Background: Liver resections have become the first-line treatment for primary malignant tumors and, therefore, are considered a core aspect of surgical training. This study aims to evaluate the learning curve for the safety of open hemihepatectomy procedures for patients suffering from hepatocellular carcinoma (HCC) or intrahepatic cholangiocarcinoma (ICC). Methods: This single tertiary center retrospective analysis includes 81 consecutive cases of right or left hemihepatectmy. A cumulative sum (CUSUM) control chart was used to investigate the learning curve. Results: The CUSUM curve for operative time and blood loss level peaked at the 29th and 30th case, respectively. The CUSUM curve for minor adverse effects (mAEs) and severe adverse effects (sAEs) showed a downward slope after the 27th and 36th procedures; the curve, however, remained within the acceptable range throughout the entire study. Conclusion: When performing open hemihepatectomies in patients with HCC and ICC, the stabilization of the operative time and intraoperative blood loss level are gained earlier than sAEs risk reduction.

Keywords: hemihepatectomy; hepatocellular carcinoma (HCC); intrahepatic cholangiocarcinoma (ICC); learning curve (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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