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1. Multisocietal European consensus on the terminology, diagnosis, and management of patients with synchronous colorectal cancer and liver metastases: an E-AHPBA consensus in partnership with ESSO, ESCP, ESGAR, and CIRSE

Author

Siriwardena, A, Serrablo, A, Fretland, A, Wigmore, S, Ramia-Angel, J, Malik, H, Stattner, S, Soreide, K, Zmora, O, Meijerink, M, Kartalis, N, Lesurtel, M, Verhoef, K, Balakrishnan, A, Gruenberger, T, Jonas, E, Devar, J, Jamdar, S, Jones, R, Hilal, M, Andersson, B, Boudjema, K, Mullamitha, S, Stassen, L, Dasari, B, Frampton, A, Aldrighetti, L, Pellino, G, Buchwald, P, Gurses, B, Wasserberg, N, Gruenberger, B, Spiers, H, Jarnagin, W, Vauthey, J, Kokudo, N, Tejpar, S, Valdivieso, A, Adam, R, Lang, H, Smith, M, Deoliveira, M, Adair, A, Gilg, S, Swijnenburg, R, Jaekers, J, Jegatheeswaran, S, Buis, C, Parks, R, Bockhorn, M, Conroy, T, Petras, P, Primavesi, F, Chan, A, Cipriani, F, Rubbia-Brandt, L, Foster, L, Abdelaal, A, Yaqub, S, Rahbari, N, Fondevila, C, Abradelo, M, Kok, N, Tejedor, L, Martinez-Baena, D, Azoulay, D, Maglione, M, Serradilla-Martin, M, Azevedo, J, Romano, F, Line, P, Forcen, T, Panis, Y, Stylianides, N, Bale, R, Quaia, E, Yassin, N, Duque, V, Espin-Basany, E, Mellenhorst, J, Rees, A, Adeyeye, A, Tuynman, J, Simillis, C, Duff, S, Wilson, R, De Nardi, P, Palmer, G, Zakaria, A, Perra, T, Porcu, A, Tamini, N, Kelly, M, Metwally, I, Morarasu, S, Carbone, F, Estaire-Gomez, M, Perez, E, Seligmann, J, Gollins, S, Braun, M, Hessheimer, A, Alonso, V, Radhakrishna, G, Alam, N, Camposorias, C, Barriuoso, J, Ross, P, Ba-Ssalamah, A, Muthu, S, Filobbos, R, Nadarajah, V, Hattab, A, Newton, C, Barker, S, Sibbald, J, Hancock, J, de Liguori Carino, N, Deshpande, R, Lancellotti, F, Paterna, S, Gutierrez-Diez, M, Artigas, C, Siriwardena A. K., Serrablo A., Fretland A. A., Wigmore S. J., Ramia-Angel J. M., Malik H. Z., Stattner S., Soreide K., Zmora O., Meijerink M., Kartalis N., Lesurtel M., Verhoef K., Balakrishnan A., Gruenberger T., Jonas E., Devar J., Jamdar S., Jones R., Hilal M. A., Andersson B., Boudjema K., Mullamitha S., Stassen L., Dasari B. V. M., Frampton A. E., Aldrighetti L., Pellino G., Buchwald P., Gurses B., Wasserberg N., Gruenberger B., Spiers H. V. M., Jarnagin W., Vauthey J. -N., Kokudo N., Tejpar S., Valdivieso A., Adam R., Lang H., Smith M., deOliveira M. L., Adair A., Gilg S., Swijnenburg R. -J., Jaekers J., Jegatheeswaran S., Buis C., Parks R., Bockhorn M., Conroy T., Petras P., Primavesi F., Chan A. K. C., Cipriani F., Rubbia-Brandt L., Foster L., Abdelaal A., Yaqub S., Rahbari N., Fondevila C., Abradelo M., Kok N. F. M., Tejedor L., Martinez-Baena D., Azoulay D., Maglione M., Serradilla-Martin M., Azevedo J., Romano F., Line P. -D., Forcen T. A., Panis Y., Stylianides N., Bale R., Quaia E., Yassin N., Duque V., Espin-Basany E., Mellenhorst J., Rees A., Adeyeye A., Tuynman J. B., Simillis C., Duff S., Wilson R., De Nardi P., Palmer G. J., Zakaria A. D., Perra T., Porcu A., Tamini N., Kelly M. E., Metwally I., Morarasu S., Carbone F., Estaire-Gomez M., Perez E. M., Seligmann J., Gollins S., Braun M., Hessheimer A., Alonso V., Radhakrishna G., Alam N., Camposorias C., Barriuoso J., Ross P., Ba-Ssalamah A., Muthu S., Filobbos R., Nadarajah V., Hattab A., Newton C., Barker S., Sibbald J., Hancock J., de Liguori Carino N., Deshpande R., Lancellotti F., Paterna S., Gutierrez-Diez M., Artigas C., Siriwardena, A, Serrablo, A, Fretland, A, Wigmore, S, Ramia-Angel, J, Malik, H, Stattner, S, Soreide, K, Zmora, O, Meijerink, M, Kartalis, N, Lesurtel, M, Verhoef, K, Balakrishnan, A, Gruenberger, T, Jonas, E, Devar, J, Jamdar, S, Jones, R, Hilal, M, Andersson, B, Boudjema, K, Mullamitha, S, Stassen, L, Dasari, B, Frampton, A, Aldrighetti, L, Pellino, G, Buchwald, P, Gurses, B, Wasserberg, N, Gruenberger, B, Spiers, H, Jarnagin, W, Vauthey, J, Kokudo, N, Tejpar, S, Valdivieso, A, Adam, R, Lang, H, Smith, M, Deoliveira, M, Adair, A, Gilg, S, Swijnenburg, R, Jaekers, J, Jegatheeswaran, S, Buis, C, Parks, R, Bockhorn, M, Conroy, T, Petras, P, Primavesi, F, Chan, A, Cipriani, F, Rubbia-Brandt, L, Foster, L, Abdelaal, A, Yaqub, S, Rahbari, N, Fondevila, C, Abradelo, M, Kok, N, Tejedor, L, Martinez-Baena, D, Azoulay, D, Maglione, M, Serradilla-Martin, M, Azevedo, J, Romano, F, Line, P, Forcen, T, Panis, Y, Stylianides, N, Bale, R, Quaia, E, Yassin, N, Duque, V, Espin-Basany, E, Mellenhorst, J, Rees, A, Adeyeye, A, Tuynman, J, Simillis, C, Duff, S, Wilson, R, De Nardi, P, Palmer, G, Zakaria, A, Perra, T, Porcu, A, Tamini, N, Kelly, M, Metwally, I, Morarasu, S, Carbone, F, Estaire-Gomez, M, Perez, E, Seligmann, J, Gollins, S, Braun, M, Hessheimer, A, Alonso, V, Radhakrishna, G, Alam, N, Camposorias, C, Barriuoso, J, Ross, P, Ba-Ssalamah, A, Muthu, S, Filobbos, R, Nadarajah, V, Hattab, A, Newton, C, Barker, S, Sibbald, J, Hancock, J, de Liguori Carino, N, Deshpande, R, Lancellotti, F, Paterna, S, Gutierrez-Diez, M, Artigas, C, Siriwardena A. K., Serrablo A., Fretland A. A., Wigmore S. J., Ramia-Angel J. M., Malik H. Z., Stattner S., Soreide K., Zmora O., Meijerink M., Kartalis N., Lesurtel M., Verhoef K., Balakrishnan A., Gruenberger T., Jonas E., Devar J., Jamdar S., Jones R., Hilal M. A., Andersson B., Boudjema K., Mullamitha S., Stassen L., Dasari B. V. M., Frampton A. E., Aldrighetti L., Pellino G., Buchwald P., Gurses B., Wasserberg N., Gruenberger B., Spiers H. V. M., Jarnagin W., Vauthey J. -N., Kokudo N., Tejpar S., Valdivieso A., Adam R., Lang H., Smith M., deOliveira M. L., Adair A., Gilg S., Swijnenburg R. -J., Jaekers J., Jegatheeswaran S., Buis C., Parks R., Bockhorn M., Conroy T., Petras P., Primavesi F., Chan A. K. C., Cipriani F., Rubbia-Brandt L., Foster L., Abdelaal A., Yaqub S., Rahbari N., Fondevila C., Abradelo M., Kok N. F. M., Tejedor L., Martinez-Baena D., Azoulay D., Maglione M., Serradilla-Martin M., Azevedo J., Romano F., Line P. -D., Forcen T. A., Panis Y., Stylianides N., Bale R., Quaia E., Yassin N., Duque V., Espin-Basany E., Mellenhorst J., Rees A., Adeyeye A., Tuynman J. B., Simillis C., Duff S., Wilson R., De Nardi P., Palmer G. J., Zakaria A. D., Perra T., Porcu A., Tamini N., Kelly M. E., Metwally I., Morarasu S., Carbone F., Estaire-Gomez M., Perez E. M., Seligmann J., Gollins S., Braun M., Hessheimer A., Alonso V., Radhakrishna G., Alam N., Camposorias C., Barriuoso J., Ross P., Ba-Ssalamah A., Muthu S., Filobbos R., Nadarajah V., Hattab A., Newton C., Barker S., Sibbald J., Hancock J., de Liguori Carino N., Deshpande R., Lancellotti F., Paterna S., Gutierrez-Diez M., and Artigas C.

Abstract

Background: Contemporary management of patients with synchronous colorectal cancer and liver metastases is complex. The aim of this project was to provide a practical framework for care of patients with synchronous colorectal cancer and liver metastases, with a focus on terminology, diagnosis, and management. Methods: This project was a multiorganizational, multidisciplinary consensus. The consensus group produced statements which focused on terminology, diagnosis, and management. Statements were refined during an online Delphi process, and those with 70 per cent agreement or above were reviewed at a final meeting. Iterations of the report were shared by electronic mail to arrive at a final agreed document comprising 12 key statements. Results: Synchronous liver metastases are those detected at the time of presentation of the primary tumour. The term 'early metachronous metastases' applies to those absent at presentation but detected within 12 months of diagnosis of the primary tumour, the term 'late metachronous metastases' applies to those detected after 12 months. 'Disappearing metastases' applies to lesions that are no longer detectable on MRI after systemic chemotherapy. Guidance was provided on the recommended composition of tumour boards, and clinical assessment in emergency and elective settings. The consensus focused on treatment pathways, including systemic chemotherapy, synchronous surgery, and the staged approach with either colorectal or liver-directed surgery as first step. Management of pulmonary metastases and the role of minimally invasive surgery was discussed. Conclusion: The recommendations of this contemporary consensus provide information of practical value to clinicians managing patients with synchronous colorectal cancer and liver metastases.

Published
2023

2. The multi-societal European consensus on the terminology, diagnosis and management of patients with synchronous colorectal cancer and liver metastases: an E-AHPBA consensus in partnership with ESSO, ESCP, ESGAR, and CIRSE

Author

Siriwardena, A, Serrablo, A, Fretland, A, Wigmore, S, Ramia-Angel, J, Malik, H, Stattner, S, Soreide, K, Zmora, O, Meijerink, M, Kartalis, N, Lesurtel, M, Verhoef, C, Balakrishnan, A, Gruenberger, T, Jonas, E, Devar, J, Jamdar, S, Jones, R, Hilal, M, Andersson, B, Boudjema, K, Mullamitha, S, Stassen, L, Dasari, B, Frampton, A, Aldrighetti, L, Pellino, G, Buchwald, P, Gurses, B, Wasserberg, N, Gruenberger, B, Spiers, H, Jarnagin, W, Vauthey, J, Kokudo, N, Tejpar, S, Valdivieso, A, Adam, R, Hauke, L, Smith, M, Deoliveira, M, Adair, A, Gilg, S, Swijnenburg, R, Jaekers, J, Jegatheeswaran, S, Buis, C, Parks, R, Bockhorn, M, Conroy, T, Petras, P, Primavesi, F, Chan, A, Cipriani, F, Rubbia-Brandt, L, Foster, L, Abdelaal, A, Yaqub, S, Rahbari, N, Fondevila, C, Abradelo, M, Kok, N, Tejedor, L, Martinez-Baena, D, Azoulay, D, Maglione, M, Serradilla-Martin, M, Azevedo, J, Romano, F, Line, P, Forcen, T, Panis, Y, Stylianides, N, Bale, R, Quaia, E, Yassin, N, Duque, V, Espin-Basany, E, Mellenhorst, J, Rees, A, Adeyeye, A, Tuynman, J, Simillis, C, Duff, S, Wilson, R, De Nardi, P, Palmer, G, Zakaria, A, Perra, T, Porcu, A, Tamini, N, Kelly, M, Metwally, I, Morarasu, S, Carbone, F, Estaire-Gomez, M, Perez, E, Seligmann, J, Gollins, S, Braun, M, Hessheimer, A, Alonso, V, Radhakrishna, G, Alam, N, Camposorias, C, Barriuoso, J, Ross, P, Ba-Ssalamah, A, Muthu, S, Filobbos, R, Nadarajah, V, Hattab, A, Newton, C, Barker, S, Sibbald, J, Hancock, J, de Liguori Carino, N, Deshpande, R, Lancellotti, F, Paterna, S, Gutierrez-Diez, M, Artigas, C, Siriwardena A. K., Serrablo A., Fretland A. A., Wigmore S. J., Ramia-Angel J. M., Malik H. Z., Stattner S., Soreide K., Zmora O., Meijerink M., Kartalis N., Lesurtel M., Verhoef C., Balakrishnan A., Gruenberger T., Jonas E., Devar J., Jamdar S., Jones R., Hilal M. A., Andersson B., Boudjema K., Mullamitha S., Stassen L., Dasari B. V. M., Frampton A. E., Aldrighetti L., Pellino G., Buchwald P., Gurses B., Wasserberg N., Gruenberger B., Spiers H. V. M., Jarnagin W., Vauthey J. -N., Kokudo N., Tejpar S., Valdivieso A., Adam R., Hauke Lang, Smith M., deOliveira M. L., Adair A., Gilg S., Swijnenburg R. -J., Jaekers J., Jegatheeswaran S., Buis C., Parks R., Bockhorn M., Conroy T., Petras P., Primavesi F., Chan A. K. C., Cipriani F., Rubbia-Brandt L., Foster L., Abdelaal A., Yaqub S., Rahbari N., Fondevila C., Abradelo M., Kok N. F., Tejedor L., Martinez-Baena D., Azoulay D., Maglione M., Serradilla-Martin M., Azevedo J., Romano F., Line P. -D., Forcen T. A., Panis Y., Stylianides N., Bale R., Quaia E., Yassin N., Duque V., Espin-Basany E., Mellenhorst J., Rees A., Adeyeye A., Tuynman J. B., Simillis C., Duff S., Wilson R., De Nardi P., Palmer G. J., Zakaria A. D., Perra T., Porcu A., Tamini N., Kelly M. E., Metwally I., Morarasu S., Carbone F., Estaire-Gomez M., Perez E. M., Seligmann J., Gollins S., Braun M., Hessheimer A., Alonso V., Radhakrishna G., Alam N., Camposorias C., Barriuoso J., Ross P., Ba-Ssalamah A., Muthu S., Filobbos R., Nadarajah V., Hattab A., Newton C., Barker S., Sibbald J., Hancock J., de Liguori Carino N., Deshpande R., Lancellotti F., Paterna S., Gutierrez-Diez M., Artigas C., Siriwardena, A, Serrablo, A, Fretland, A, Wigmore, S, Ramia-Angel, J, Malik, H, Stattner, S, Soreide, K, Zmora, O, Meijerink, M, Kartalis, N, Lesurtel, M, Verhoef, C, Balakrishnan, A, Gruenberger, T, Jonas, E, Devar, J, Jamdar, S, Jones, R, Hilal, M, Andersson, B, Boudjema, K, Mullamitha, S, Stassen, L, Dasari, B, Frampton, A, Aldrighetti, L, Pellino, G, Buchwald, P, Gurses, B, Wasserberg, N, Gruenberger, B, Spiers, H, Jarnagin, W, Vauthey, J, Kokudo, N, Tejpar, S, Valdivieso, A, Adam, R, Hauke, L, Smith, M, Deoliveira, M, Adair, A, Gilg, S, Swijnenburg, R, Jaekers, J, Jegatheeswaran, S, Buis, C, Parks, R, Bockhorn, M, Conroy, T, Petras, P, Primavesi, F, Chan, A, Cipriani, F, Rubbia-Brandt, L, Foster, L, Abdelaal, A, Yaqub, S, Rahbari, N, Fondevila, C, Abradelo, M, Kok, N, Tejedor, L, Martinez-Baena, D, Azoulay, D, Maglione, M, Serradilla-Martin, M, Azevedo, J, Romano, F, Line, P, Forcen, T, Panis, Y, Stylianides, N, Bale, R, Quaia, E, Yassin, N, Duque, V, Espin-Basany, E, Mellenhorst, J, Rees, A, Adeyeye, A, Tuynman, J, Simillis, C, Duff, S, Wilson, R, De Nardi, P, Palmer, G, Zakaria, A, Perra, T, Porcu, A, Tamini, N, Kelly, M, Metwally, I, Morarasu, S, Carbone, F, Estaire-Gomez, M, Perez, E, Seligmann, J, Gollins, S, Braun, M, Hessheimer, A, Alonso, V, Radhakrishna, G, Alam, N, Camposorias, C, Barriuoso, J, Ross, P, Ba-Ssalamah, A, Muthu, S, Filobbos, R, Nadarajah, V, Hattab, A, Newton, C, Barker, S, Sibbald, J, Hancock, J, de Liguori Carino, N, Deshpande, R, Lancellotti, F, Paterna, S, Gutierrez-Diez, M, Artigas, C, Siriwardena A. K., Serrablo A., Fretland A. A., Wigmore S. J., Ramia-Angel J. M., Malik H. Z., Stattner S., Soreide K., Zmora O., Meijerink M., Kartalis N., Lesurtel M., Verhoef C., Balakrishnan A., Gruenberger T., Jonas E., Devar J., Jamdar S., Jones R., Hilal M. A., Andersson B., Boudjema K., Mullamitha S., Stassen L., Dasari B. V. M., Frampton A. E., Aldrighetti L., Pellino G., Buchwald P., Gurses B., Wasserberg N., Gruenberger B., Spiers H. V. M., Jarnagin W., Vauthey J. -N., Kokudo N., Tejpar S., Valdivieso A., Adam R., Hauke Lang, Smith M., deOliveira M. L., Adair A., Gilg S., Swijnenburg R. -J., Jaekers J., Jegatheeswaran S., Buis C., Parks R., Bockhorn M., Conroy T., Petras P., Primavesi F., Chan A. K. C., Cipriani F., Rubbia-Brandt L., Foster L., Abdelaal A., Yaqub S., Rahbari N., Fondevila C., Abradelo M., Kok N. F., Tejedor L., Martinez-Baena D., Azoulay D., Maglione M., Serradilla-Martin M., Azevedo J., Romano F., Line P. -D., Forcen T. A., Panis Y., Stylianides N., Bale R., Quaia E., Yassin N., Duque V., Espin-Basany E., Mellenhorst J., Rees A., Adeyeye A., Tuynman J. B., Simillis C., Duff S., Wilson R., De Nardi P., Palmer G. J., Zakaria A. D., Perra T., Porcu A., Tamini N., Kelly M. E., Metwally I., Morarasu S., Carbone F., Estaire-Gomez M., Perez E. M., Seligmann J., Gollins S., Braun M., Hessheimer A., Alonso V., Radhakrishna G., Alam N., Camposorias C., Barriuoso J., Ross P., Ba-Ssalamah A., Muthu S., Filobbos R., Nadarajah V., Hattab A., Newton C., Barker S., Sibbald J., Hancock J., de Liguori Carino N., Deshpande R., Lancellotti F., Paterna S., Gutierrez-Diez M., and Artigas C.

Abstract

Background: Contemporary management of patients with synchronous colorectal cancer and liver metastases is complex. The aim of this project was to provide a practical framework for care of patients with synchronous colorectal cancer and liver metastases with a focus on terminology, diagnosis and management. Methods: This project was a multi-organisational, multidisciplinary consensus. The consensus group produced statements which focused on terminology, diagnosis and management. Statements were refined during an online Delphi process and those with 70% agreement or above were reviewed at a final meeting. Iterations of the report were shared by electronic mail to arrive at a final agreed document comprising twelve key statements. Results: Synchronous liver metastases are those detected at the time of presentation of the primary tumour. The term “early metachronous metastases” applies to those absent at presentation but detected within 12 months of diagnosis of the primary tumour with “late metachronous metastases” applied to those detected after 12 months. Disappearing metastases applies to lesions which are no longer detectable on MR scan after systemic chemotherapy. Guidance was provided on the recommended composition of tumour boards and clinical assessment in emergency and elective settings. The consensus focused on treatment pathways including systemic chemotherapy, synchronous surgery and the staged approach with either colorectal or liver-directed surgery as first step. Management of pulmonary metastases and the role of minimally invasive surgery was discussed. Conclusions: The recommendations of this contemporary consensus provide information of practical value to clinicians managing patients with synchronous colorectal cancer and liver metastases.

Published
2023

3. Training curriculum in minimally invasive emergency digestive surgery: 2022 WSES position paper

Author

De'Angelis, N, Marchegiani, F, Schena, C, Khan, J, Agnoletti, V, Ansaloni, L, Barria Rodriguez, A, Bianchi, P, Biffl, W, Bravi, F, Ceccarelli, G, Ceresoli, M, Chiara, O, Chirica, M, Cobianchi, L, Coccolini, F, Coimbra, R, Cotsoglou, C, D'Hondt, M, Damaskos, D, De Simone, B, Di Saverio, S, Diana, M, Espin-Basany, E, Fichtner-Feigl, S, Fugazzola, P, Gavriilidis, P, Gronnier, C, Kashuk, J, Kirkpatrick, A, Ammendola, M, Kouwenhoven, E, Laurent, A, Leppaniemi, A, Lesurtel, M, Memeo, R, Milone, M, Moore, E, Pararas, N, Peitzmann, A, Pessaux, P, Picetti, E, Pikoulis, M, Pisano, M, Ris, F, Robison, T, Sartelli, M, Shelat, V, Spinoglio, G, Sugrue, M, Tan, E, Van Eetvelde, E, Kluger, Y, Weber, D, Catena, F, de'Angelis N., Marchegiani F., Schena C. A., Khan J., Agnoletti V., Ansaloni L., Barria Rodriguez A. G., Bianchi P. P., Biffl W., Bravi F., Ceccarelli G., Ceresoli M., Chiara O., Chirica M., Cobianchi L., Coccolini F., Coimbra R., Cotsoglou C., D'Hondt M., Damaskos D., De Simone B., Di Saverio S., Diana M., Espin-Basany E., Fichtner-Feigl S., Fugazzola P., Gavriilidis P., Gronnier C., Kashuk J., Kirkpatrick A. W., Ammendola M., Kouwenhoven E. A., Laurent A., Leppaniemi A., Lesurtel M., Memeo R., Milone M., Moore E., Pararas N., Peitzmann A., Pessaux P., Picetti E., Pikoulis M., Pisano M., Ris F., Robison T., Sartelli M., Shelat V. G., Spinoglio G., Sugrue M., Tan E., Van Eetvelde E., Kluger Y., Weber D., Catena F., De'Angelis, N, Marchegiani, F, Schena, C, Khan, J, Agnoletti, V, Ansaloni, L, Barria Rodriguez, A, Bianchi, P, Biffl, W, Bravi, F, Ceccarelli, G, Ceresoli, M, Chiara, O, Chirica, M, Cobianchi, L, Coccolini, F, Coimbra, R, Cotsoglou, C, D'Hondt, M, Damaskos, D, De Simone, B, Di Saverio, S, Diana, M, Espin-Basany, E, Fichtner-Feigl, S, Fugazzola, P, Gavriilidis, P, Gronnier, C, Kashuk, J, Kirkpatrick, A, Ammendola, M, Kouwenhoven, E, Laurent, A, Leppaniemi, A, Lesurtel, M, Memeo, R, Milone, M, Moore, E, Pararas, N, Peitzmann, A, Pessaux, P, Picetti, E, Pikoulis, M, Pisano, M, Ris, F, Robison, T, Sartelli, M, Shelat, V, Spinoglio, G, Sugrue, M, Tan, E, Van Eetvelde, E, Kluger, Y, Weber, D, Catena, F, de'Angelis N., Marchegiani F., Schena C. A., Khan J., Agnoletti V., Ansaloni L., Barria Rodriguez A. G., Bianchi P. P., Biffl W., Bravi F., Ceccarelli G., Ceresoli M., Chiara O., Chirica M., Cobianchi L., Coccolini F., Coimbra R., Cotsoglou C., D'Hondt M., Damaskos D., De Simone B., Di Saverio S., Diana M., Espin-Basany E., Fichtner-Feigl S., Fugazzola P., Gavriilidis P., Gronnier C., Kashuk J., Kirkpatrick A. W., Ammendola M., Kouwenhoven E. A., Laurent A., Leppaniemi A., Lesurtel M., Memeo R., Milone M., Moore E., Pararas N., Peitzmann A., Pessaux P., Picetti E., Pikoulis M., Pisano M., Ris F., Robison T., Sartelli M., Shelat V. G., Spinoglio G., Sugrue M., Tan E., Van Eetvelde E., Kluger Y., Weber D., and Catena F.

Abstract

Background: Minimally invasive surgery (MIS), including laparoscopic and robotic approaches, is widely adopted in elective digestive surgery, but selectively used for surgical emergencies. The present position paper summarizes the available evidence concerning the learning curve to achieve proficiency in emergency MIS and provides five expert opinion statements, which may form the basis for developing standardized curricula and training programs in emergency MIS. Methods: This position paper was conducted according to the World Society of Emergency Surgery methodology. A steering committee and an international expert panel were involved in the critical appraisal of the literature and the development of the consensus statements. Results: Thirteen studies regarding the learning curve in emergency MIS were selected. All but one study considered laparoscopic appendectomy. Only one study reported on emergency robotic surgery. In most of the studies, proficiency was achieved after an average of 30 procedures (range: 20–107) depending on the initial surgeon’s experience. High heterogeneity was noted in the way the learning curve was assessed. The experts claim that further studies investigating learning curve processes in emergency MIS are needed. The emergency surgeon curriculum should include a progressive and adequate training based on simulation, supervised clinical practice (proctoring), and surgical fellowships. The results should be evaluated by adopting a credentialing system to ensure quality standards. Surgical proficiency should be maintained with a minimum caseload and constantly evaluated. Moreover, the training process should involve the entire surgical team to facilitate the surgeon’s proficiency. Conclusions: Limited evidence exists concerning the learning process in laparoscopic and robotic emergency surgery. The proposed statements should be seen as a preliminary guide for the surgical community while stressing the need for further research.

Published
2023

4. Are the current difficulty scores for laparoscopic liver surgery telling the whole story? An international survey and recommendations for the future

Author

Abu Hilal, M., Aldrighetti, L., Al Saati, H., Alseidi, A., Aroori, S., Belli, G., Besselink, M., Edwin, B., D'Hondt, M., Dagher, I., Dejong, C., Geller, D., Hamady, Z., Hamoui, M., Isaksson, B., Ivanecz, A., Le Roux, G., Lesurtel, M., O'Rouke, N., Prasad, R., Prieto Calvo, M., Reddy, S., Rotellar, F., Santoyo, J., Soonawalla, Z., Soubrane, O., Stavrou, G., Subar, D., Sutcliffe, R., Tanis, P., Troisi, R., Van Dam, Ronald, Wakabayashi, G., White, S., Halls, Mark C., Cherqui, Daniel, Taylor, Mark A., Primrose, John N., and Abu Hilal, Mohammed

Published
2018
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6. Training curriculum in minimally invasive emergency digestive surgery: 2022 WSES position paper.

Author

De'Angelis, N., Marchegiani, F., Schena, C.A., Khan, J., Agnoletti, V., Ansaloni, L., arría Rodríguez, A.G. B, Bianchi, P.P., Biffl, W., Bravi, F., Ceccarelli, G., Ceresoli, M., Chiara, O., Chirica, M., Cobianchi, L., Coccolini, F., Coimbra, R., Cotsoglou, C., D'Hondt, M., Damaskos, D., Simone, B. De, Saverio, S. Di, Diana, M., Espin-Basany, E., Fichtner-Feigl, S., Fugazzola, P., Gavriilidis, P., Gronnier, C., Kashuk, J., Kirkpatrick, A.W., Ammendola, M., Kouwenhoven, E.A., Laurent, A., Leppaniemi, A., Lesurtel, M., Memeo, R., Milone, M., Moore, E., Pararas, N., Peitzmann, A., Pessaux, P., Picetti, E., Pikoulis, M., Pisano, M., Ris, F., Robison, T., Sartelli, M., Shelat, V.G., Spinoglio, G., Sugrue, M., Tan, E.C.T.H., Eetvelde, E. Van, Kluger, Y., Weber, D., Catena, F., De'Angelis, N., Marchegiani, F., Schena, C.A., Khan, J., Agnoletti, V., Ansaloni, L., arría Rodríguez, A.G. B, Bianchi, P.P., Biffl, W., Bravi, F., Ceccarelli, G., Ceresoli, M., Chiara, O., Chirica, M., Cobianchi, L., Coccolini, F., Coimbra, R., Cotsoglou, C., D'Hondt, M., Damaskos, D., Simone, B. De, Saverio, S. Di, Diana, M., Espin-Basany, E., Fichtner-Feigl, S., Fugazzola, P., Gavriilidis, P., Gronnier, C., Kashuk, J., Kirkpatrick, A.W., Ammendola, M., Kouwenhoven, E.A., Laurent, A., Leppaniemi, A., Lesurtel, M., Memeo, R., Milone, M., Moore, E., Pararas, N., Peitzmann, A., Pessaux, P., Picetti, E., Pikoulis, M., Pisano, M., Ris, F., Robison, T., Sartelli, M., Shelat, V.G., Spinoglio, G., Sugrue, M., Tan, E.C.T.H., Eetvelde, E. Van, Kluger, Y., Weber, D., and Catena, F.

Abstract

Item does not contain fulltext, BACKGROUND: Minimally invasive surgery (MIS), including laparoscopic and robotic approaches, is widely adopted in elective digestive surgery, but selectively used for surgical emergencies. The present position paper summarizes the available evidence concerning the learning curve to achieve proficiency in emergency MIS and provides five expert opinion statements, which may form the basis for developing standardized curricula and training programs in emergency MIS. METHODS: This position paper was conducted according to the World Society of Emergency Surgery methodology. A steering committee and an international expert panel were involved in the critical appraisal of the literature and the development of the consensus statements. RESULTS: Thirteen studies regarding the learning curve in emergency MIS were selected. All but one study considered laparoscopic appendectomy. Only one study reported on emergency robotic surgery. In most of the studies, proficiency was achieved after an average of 30 procedures (range: 20-107) depending on the initial surgeon's experience. High heterogeneity was noted in the way the learning curve was assessed. The experts claim that further studies investigating learning curve processes in emergency MIS are needed. The emergency surgeon curriculum should include a progressive and adequate training based on simulation, supervised clinical practice (proctoring), and surgical fellowships. The results should be evaluated by adopting a credentialing system to ensure quality standards. Surgical proficiency should be maintained with a minimum caseload and constantly evaluated. Moreover, the training process should involve the entire surgical team to facilitate the surgeon's proficiency. CONCLUSIONS: Limited evidence exists concerning the learning process in laparoscopic and robotic emergency surgery. The proposed statements should be seen as a preliminary guide for the surgical community while stressing the need for further research.

Published
2023

7. Utilization of livers donated after circulatory death for transplantation - An international comparison

Author

Eden, J, Da Silva, R, Cortes-Cerisuelo, M, Croome, K, De Carlis, R, Hessheimer, A, Muller, X, de Goeij, F, Banz, V, Magini, G, Compagnon, P, Elmer, A, Lauterio, A, Panconesi, R, Widmer, J, Dondossola, D, Muiesan, P, Monbaliu, D, de Rosner van Rosmalen, M, Detry, O, Fondevila, C, Jochmans, I, Pirenne, J, Immer, F, Oniscu, G, de Jonge, J, Lesurtel, M, De Carlis, L, Taner, C, Heaton, N, Schlegel, A, Dutkowski, P, Eden, Janina, Da Silva, Richard Sousa, Cortes-Cerisuelo, Miriam, Croome, Kristopher, De Carlis, Riccardo, Hessheimer, Amelia J, Muller, Xavier, de Goeij, Femke, Banz, Vanessa, Magini, Giulia, Compagnon, Philippe, Elmer, Andreas, Lauterio, Andrea, Panconesi, Rebecca, Widmer, Jeannette, Dondossola, Daniele, Muiesan, Paolo, Monbaliu, Diethard, de Rosner van Rosmalen, Marieke, Detry, Olivier, Fondevila, Constantino, Jochmans, Ina, Pirenne, Jacques, Immer, Franz, Oniscu, Gabriel C, de Jonge, Jeroen, Lesurtel, Mickaël, De Carlis, Luciano G, Taner, C Burcin, Heaton, Nigel, Schlegel, Andrea, Dutkowski, Philipp, Eden, J, Da Silva, R, Cortes-Cerisuelo, M, Croome, K, De Carlis, R, Hessheimer, A, Muller, X, de Goeij, F, Banz, V, Magini, G, Compagnon, P, Elmer, A, Lauterio, A, Panconesi, R, Widmer, J, Dondossola, D, Muiesan, P, Monbaliu, D, de Rosner van Rosmalen, M, Detry, O, Fondevila, C, Jochmans, I, Pirenne, J, Immer, F, Oniscu, G, de Jonge, J, Lesurtel, M, De Carlis, L, Taner, C, Heaton, N, Schlegel, A, Dutkowski, P, Eden, Janina, Da Silva, Richard Sousa, Cortes-Cerisuelo, Miriam, Croome, Kristopher, De Carlis, Riccardo, Hessheimer, Amelia J, Muller, Xavier, de Goeij, Femke, Banz, Vanessa, Magini, Giulia, Compagnon, Philippe, Elmer, Andreas, Lauterio, Andrea, Panconesi, Rebecca, Widmer, Jeannette, Dondossola, Daniele, Muiesan, Paolo, Monbaliu, Diethard, de Rosner van Rosmalen, Marieke, Detry, Olivier, Fondevila, Constantino, Jochmans, Ina, Pirenne, Jacques, Immer, Franz, Oniscu, Gabriel C, de Jonge, Jeroen, Lesurtel, Mickaël, De Carlis, Luciano G, Taner, C Burcin, Heaton, Nigel, Schlegel, Andrea, and Dutkowski, Philipp

Abstract

Background and aim: Liver graft utilization rates are a hot topic due to the worldwide organ shortage and an increasing number of transplant candidates on waiting lists. Liver perfusion techniques have been introduced in several countries, and may help to increase the organ supply, as they potentially allow the assessment of livers before use. Methods: Liver offers were counted from donation after circulatory death (DCD) donors (Maastricht-type-III) arising during the past decade in eight countries, including Belgium, France, Italy, the Netherlands, Spain, Switzerland, UK, and US. Initial DCD-type-III liver offers were correlated with accepted, recovered and implanted livers. Results: A total number of 34`269 DCD livers were offered, resulting in 9`780 liver transplants (28.5%). The discard rates were highest in UK and US, ranging between 70 and 80%. In contrast, much lower DCD liver discard rates, e.g., between 30-40%, were found in Belgium, France, Italy, Spain and Switzerland. In addition, large differences were recognized in the use of various machine perfusion techniques, and in terms of risk factors in the cohorts of implanted livers. For example, the median donor age and functional donor warm ischemia were highest in Italy, e.g., >40minutes, followed by Switzerland, France, and the Netherlands. Importantly, such varying risk profiles of accepted DCD livers between countries did not translate into large differences in five-year graft survival rates, which ranged between 60-82% in this analysis. Conclusions: We highlight a significant number of discarded and consequently unused DCD liver offers. Countries with more routine use of in- and ex-situ machine perfusion strategies showed better DCD utilization rates without compromised outcome. Impact and implications: A significant number of Maastricht type III DCD livers are discarded across Europe and North America today. The overall utilization rate among eight Western countries is 28.5%, but varies significant

Published
2023

14. Intraductal Papillary Neoplasms of the Bile Duct. A Comparative Study of Tumor Characteristics, Management Strategies and Outcomes in Europe and Nagoya, Japan

Author

Lluís, N., primary, Onoe, S., additional, Serradilla Martín, M., additional, Achalandabaso, M., additional, Mizuno, T., additional, Hoogwater, F.H., additional, Yamaguchi, J., additional, Charco, R., additional, Ebata, T., additional, Lesurtel, M., additional, and Ramia, J.M., additional

Published
2023
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33. COVID-19 in liver transplant candidates: Pretransplant and post-transplant outcomes - An ELITA/ELTR multicentre cohort study

Author

Belli, L, Duvoux, C, Cortesi, P, Facchetti, R, Iacob, S, Perricone, G, Radenne, S, Conti, S, Patrono, D, Berlakovich, G, Hann, A, Pasulo, L, Castells, L, Faitot, F, Detry, O, Invernizzi, F, Magini, G, De Simone, P, Kounis, I, Morelli, M, Diaz Fontenla, F, Ericzon, B, Loinaz, C, Johnston, C, Gheorghe, L, Lesurtel, M, Romagnoli, R, Kollmann, D, Perera, M, Fagiuoli, S, Mirza, D, Coilly, A, Toso, C, Zieniewicz, K, Elkrief, L, Karam, V, Adam, R, Den Hoed, C, Merli, M, Puoti, M, De Carlis, L, Oniscu, G, Piano, S, Angeli, P, Fondevila, C, Polak, W, Belli L. S., Duvoux C., Cortesi P. A., Facchetti R., Iacob S., Perricone G., Radenne S., Conti S., Patrono D., Berlakovich G., Hann A., Pasulo L., Castells L., Faitot F., Detry O., Invernizzi F., Magini G., De Simone P., Kounis I., Morelli M. C., Diaz Fontenla F., Ericzon B. -G., Loinaz C., Johnston C., Gheorghe L., Lesurtel M., Romagnoli R., Kollmann D., Perera M. T. P. R., Fagiuoli S., Mirza D., Coilly A., Toso C., Zieniewicz K., Elkrief L., Karam V., Adam R., Den Hoed C., Merli M., Puoti M., De Carlis L., Oniscu G. C., Piano S., Angeli P., Fondevila C., Polak W. G., Belli, L, Duvoux, C, Cortesi, P, Facchetti, R, Iacob, S, Perricone, G, Radenne, S, Conti, S, Patrono, D, Berlakovich, G, Hann, A, Pasulo, L, Castells, L, Faitot, F, Detry, O, Invernizzi, F, Magini, G, De Simone, P, Kounis, I, Morelli, M, Diaz Fontenla, F, Ericzon, B, Loinaz, C, Johnston, C, Gheorghe, L, Lesurtel, M, Romagnoli, R, Kollmann, D, Perera, M, Fagiuoli, S, Mirza, D, Coilly, A, Toso, C, Zieniewicz, K, Elkrief, L, Karam, V, Adam, R, Den Hoed, C, Merli, M, Puoti, M, De Carlis, L, Oniscu, G, Piano, S, Angeli, P, Fondevila, C, Polak, W, Belli L. S., Duvoux C., Cortesi P. A., Facchetti R., Iacob S., Perricone G., Radenne S., Conti S., Patrono D., Berlakovich G., Hann A., Pasulo L., Castells L., Faitot F., Detry O., Invernizzi F., Magini G., De Simone P., Kounis I., Morelli M. C., Diaz Fontenla F., Ericzon B. -G., Loinaz C., Johnston C., Gheorghe L., Lesurtel M., Romagnoli R., Kollmann D., Perera M. T. P. R., Fagiuoli S., Mirza D., Coilly A., Toso C., Zieniewicz K., Elkrief L., Karam V., Adam R., Den Hoed C., Merli M., Puoti M., De Carlis L., Oniscu G. C., Piano S., Angeli P., Fondevila C., and Polak W. G.

Abstract

Objective: Explore the impact of COVID-19 on patients on the waiting list for liver transplantation (LT) and on their post-LT course. Design: Data from consecutive adult LT candidates with COVID-19 were collected across Europe in a dedicated registry and were analysed. Results: From 21 February to 20 November 2020, 136 adult cases with laboratory-confirmed SARS-CoV-2 infection from 33 centres in 11 European countries were collected, with 113 having COVID-19. Thirty-seven (37/113, 32.7%) patients died after a median of 18 (10-30) days, with respiratory failure being the major cause (33/37, 89.2%). The 60-day mortality risk did not significantly change between first (35.3%, 95% CI 23.9% to 50.0%) and second (26.0%, 95% CI 16.2% to 40.2%) waves. Multivariable Cox regression analysis showed Laboratory Model for End-stage Liver Disease (Lab-MELD) score of ≥15 (Model for End-stage Liver Disease (MELD) score 15-19, HR 5.46, 95% CI 1.81 to 16.50; MELD score≥20, HR 5.24, 95% CI 1.77 to 15.55) and dyspnoea on presentation (HR 3.89, 95% CI 2.02 to 7.51) being the two negative independent factors for mortality. Twenty-six patients underwent an LT after a median time of 78.5 (IQR 44-102) days, and 25 (96%) were alive after a median follow-up of 118 days (IQR 31-170). Conclusions: Increased mortality in LT candidates with COVID-19 (32.7%), reaching 45% in those with decompensated cirrhosis (DC) and Lab-MELD score of ≥15, was observed, with no significant difference between first and second waves of the pandemic. Respiratory failure was the major cause of death. The dismal prognosis of patients with DC supports the adoption of strict preventative measures and the urgent testing of vaccination efficacy in this population. Prior SARS-CoV-2 symptomatic infection did not affect early post-transplant survival (96%).

Published
2021

34. Risk score to predict biliary leakage after elective liver resection

Author

Mohkam, K., Farges, O., Vibert, E., Soubrane, O., Adam, R., Pruvot, F.‐R., Regimbeau, J.‐M., Adham, M., Boleslawski, E., Mabrut, J.‐Y., Ducerf, C., Pradat, P., Darnis, B., Cazauran, J.‐B., Lesurtel, M., Dokmak, S., Aussilhou, B., Dondero, F., Allard, M.‐A., Ciacio, O., Pittau, G., Cherqui, D., Castaing, D., Sa Cunha, A., Truant, S., Hardwigsen, J., Le Treut, Y.‐P., Grégoire, E., Scatton, O., Brustia, R., Sepulveda, A., Cosse, C., Laurent, C., Adam, J.‐P., El Bechwaty, M., and Perinel, J.

Published
2018
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35. Liver resection and ablation for squamous cell carcinoma liver metastases

Author

Engstrand, J, Abreu De Carvalho, LF, Aghayan, D, Balakrishnan, A, Belli, A, Björnsson, B, Dasari, BVM, Detry, O, Di Martino, M, Edwin, B, Erdmann, J, Fristedt, R, Fusai, G, Gimenez-Maurel, T, Hemmingsson, O, Hidalgo Salinas, C, Isaksson, B, Ivanecz, A, Izzo, F, Knoefel, WT, Kron, P, Lehwald-Tywuschik, N, Lesurtel, M, Lodge, JPA, Machairas, N, Marino, MV, Martin, V, Paterson, A, Rystedt, J, Sandström, P, Serrablo, A, Siriwardena, AK, Taflin, H, Van Gulik, TM, Yaqub, S, Özden, I, Ramia, JM, Sturesson, C, E-AHPBA Scientific And Research Committee, Engstrand, J [0000-0003-1123-7022], Aghayan, D [0000-0001-7051-3512], Belli, A [0000-0002-6252-573X], Detry, O [0000-0002-9436-6673], Di Martino, M [0000-0001-6510-7210], Hemmingsson, O [0000-0003-1732-168X], Lesurtel, M [0000-0003-2397-4599], Lodge, JPA [0000-0001-8771-4214], Machairas, N [0000-0003-3239-3905], Marino, MV [0000-0002-0466-4467], Rystedt, J [0000-0002-8865-9963], Yaqub, S [0000-0002-5696-2319], Ramia, JM [0000-0001-7734-9479], Sturesson, C [0000-0003-3451-2840], and Apollo - University of Cambridge Repository

Subjects
RISK, Liver Neoplasms, HEPATIC RESECTION, General Medicine, CANCER, Cohort Studies, NEUROENDOCRINE, Medicine and Health Sciences, SURVIVAL, Carcinoma, Squamous Cell, Humans, HEAD, Neoplasm Recurrence, Local, Retrospective Studies
Abstract

Funder: Region Stockholm, Funder: Region Stockholm (clinical postdoctoral appointment), BACKGROUND: Limited evidence exists to guide the management of patients with liver metastases from squamous cell carcinoma (SCC). The aim of this retrospective multicentre cohort study was to describe patterns of disease recurrence after liver resection/ablation for SCC liver metastases and factors associated with recurrence-free survival (RFS) and overall survival (OS). METHOD: Members of the European-African Hepato-Pancreato-Biliary Association were invited to include all consecutive patients undergoing liver resection/ablation for SCC liver metastases between 2002 and 2019. Patient, tumour and perioperative characteristics were analysed with regard to RFS and OS. RESULTS: Among the 102 patients included from 24 European centres, 56 patients had anal cancer, and 46 patients had SCC from other origin. RFS in patients with anal cancer and non-anal cancer was 16 and 9 months, respectively (P = 0.134). A positive resection margin significantly influenced RFS for both anal cancer and non-anal cancer liver metastases (hazard ratio 6.82, 95 per cent c.i. 2.40 to 19.35, for the entire cohort). Median survival duration and 5-year OS rate among patients with anal cancer and non-anal cancer were 50 months and 45 per cent and 21 months and 25 per cent, respectively. For the entire cohort, only non-radical resection was associated with worse overall survival (hazard ratio 3.21, 95 per cent c.i. 1.24 to 8.30). CONCLUSION: Liver resection/ablation of liver metastases from SCC can result in long-term survival. Survival was superior in treated patients with liver metastases from anal versus non-anal cancer. A negative resection margin is paramount for acceptable outcome.

Published
2021
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36. Clinical outcomes after total pancreatectomy: a prospective multicenter pan-European snapshot study

Author

Erkan, Murat Mert (ORCID 0000-0002-2753-0234 & YÖK ID 214689), Latenstein, A.E.J.; Scholten, L.; Al-Saffar, H.A.; Björnsson, B.; Butturini, G.; Capretti, G.; Chatzizacharias, N.A.; Dervenis, C.; Frigerio, I.; Gallagher, T.K.; Gasteiger, S.; Halimi, A.; Labori, K.J.; Montagnini, G.; Muñoz-Bellvis, L.; Nappo, G.; Nikov, A.; Pando, E.; Pastena, M.D.; Peña-Moral, J.M.D.L.; Radenkovic, D.; Roberts, K.J.; Salvia, R.; Sanchez-Bueno, F.; Scandavini, C.; Serradilla-Martin, M.; Stättner, S.; Tomazic, A.; Varga, M.; Zavrtanik, H.; Zerbi, A.; Kleeff, J.; Lesurtel, M.; Besselink, M.G.; Ramia-Angel, J.M.; Scientific, Research Committee of the European-African Hepato-Pancreato-Biliary Association (E-AHPBA), School of Medicine, Erkan, Murat Mert (ORCID 0000-0002-2753-0234 & YÖK ID 214689), Latenstein, A.E.J.; Scholten, L.; Al-Saffar, H.A.; Björnsson, B.; Butturini, G.; Capretti, G.; Chatzizacharias, N.A.; Dervenis, C.; Frigerio, I.; Gallagher, T.K.; Gasteiger, S.; Halimi, A.; Labori, K.J.; Montagnini, G.; Muñoz-Bellvis, L.; Nappo, G.; Nikov, A.; Pando, E.; Pastena, M.D.; Peña-Moral, J.M.D.L.; Radenkovic, D.; Roberts, K.J.; Salvia, R.; Sanchez-Bueno, F.; Scandavini, C.; Serradilla-Martin, M.; Stättner, S.; Tomazic, A.; Varga, M.; Zavrtanik, H.; Zerbi, A.; Kleeff, J.; Lesurtel, M.; Besselink, M.G.; Ramia-Angel, J.M.; Scientific, Research Committee of the European-African Hepato-Pancreato-Biliary Association (E-AHPBA), and School of Medicine

Abstract

Objective: To assess outcomes among patients undergoing total pancreatectomy (TP) including predictors for complications and in-hospital mortality. Background: Current studies on TP mostly originate from high-volume centers and span long time periods and therefore may not reflect daily practice. Methods: This prospective pan-European snapshot study included patients who underwent elective (primary or completion) TP in 43 centers in 16 European countries (June 2018-June 2019). Subgroup analysis included cutoff values for annual volume of pancreatoduodenectomies (<60 vs 60). Predictors for major complications and in-hospital mortality were assessed in multivariable logistic regression. Results: In total, 277 patients underwent TP, mostly for malignant disease (73%). Major postoperative complications occurred in 70 patients (25%). Median hospital stay was 12 days (IQR 9-18) and 40 patients were readmitted (15%). In-hospital mortality was 5% and 90-day mortality 8%. In the subgroup analysis, in-hospital mortality was lower in patients operated in centers with 60 pancreatoduodenectomies compared <60 (4% vs 10%, P = 0.046). In multivariable analysis, annual volume <60 pancreatoduodenectomies (OR 3.78, 95% CI 1.18-12.16, P = 0.026), age (OR 1.07, 95% CI 1.01-1.14, P = 0.046), and estimated blood loss 2L (OR 11.89, 95% CI 2.64-53.61, P = 0.001) were associated with in-hospital mortality. ASA 3 (OR 2.87, 95% CI 1.56-5.26, P = 0.001) and estimated blood loss 2L (OR 3.52, 95% CI 1.25-9.90, P = 0.017) were associated with major complications. Conclusion: This pan-European prospective snapshot study found a 5% inhospital mortality after TP. The identified predictors for mortality, including low-volume centers, age, and increased blood loss, may be used to improve outcomes., NA

Published
2022

37. Location and allocation: inequity of access to liver transplantation for patients with severe acute‐on‐chronic liver failure in Europe

Author

Artzner, T, Bernal, W, Belli, L, Conti, S, Cortesi, P, Sacleux, S, Pageaux, G, Radenne, S, Trebicka, J, Fernandez, J, Perricone, G, Piano, S, Nadalin, S, Morelli, M, Martini, S, Polak, W, Zieniewicz, K, Toso, C, Berenguer, M, Iegri, C, Invernizzi, F, Volpes, R, Karam, V, Adam, R, Faitot, F, Rabinowich, L, Saliba, F, Meunier, L, Lesurtel, M, Uschner, F, Michard, B, Coilly, A, Meszaros, M, Poinsot, D, Besch, C, Schnitzbauer, A, De Carlis, L, Fumagalli, R, Angeli, P, Arroyo, V, Fondevila, C, Duvoux, C, Jalan, R, Viganò, R, Mazzarelli, C, Lauterio, A, Giacomoni, A, Donato, F, Lampertico, P, Pasulo, L, Fagiuoli, S, Colledan, M, Cristina Morelli, M, Vitale, G, Ottobrelli, A, Patrono, D, Romagnoli, R, Petridis, I, Cillo, U, Germani, G, Burra, P, Bachellier, P, Schneider, F, Castelain, V, Addeo, P, Deridder, M, Caroline Sacleux Audrey Coilly, S, Faouzi, S, Samuel, D, Guichon, C, Faure, S, Ursic‐bedoya, J, Colmenero, J, Toapanta, D, Hernández‐tejero, M, Vinaixa, C, den Hoed, C, Haan, J, Della Penna, A, Erhard Uschner, F, Welker, M, Zeuzem, S, Bechstein, W, Goossens, N, Raszeja‐wyszomirska, J, Rabinovich, L, Katarey, D, Agarwal, B, Artzner, Thierry, Bernal, William, Belli, Luca S, Conti, Sara, Cortesi, Paolo A, Sacleux, Sophie‐Caroline, Pageaux, George‐Philippe, Radenne, Sylvie, Trebicka, Jonel, Fernandez, Javier, Perricone, Giovanni, Piano, Salvatore, Nadalin, Silvio, Morelli, Maria C, Martini, Silvia, Polak, Wojciech G, Zieniewicz, Krzysztof, Toso, Christian, Berenguer, Marina, Iegri, Claudia, Invernizzi, Federica, Volpes, Riccardo, Karam, Vincent, Adam, René, Faitot, François, Rabinowich, Liane, Saliba, Faouzi, Meunier, Lucy, Lesurtel, Mickael, Uschner, Frank E, Michard, Baptiste, Coilly, Audrey, Meszaros, Magdalena, Poinsot, Domitille, Besch, Camille, Schnitzbauer, Andreas, De Carlis, Luciano G, Fumagalli, Roberto, Angeli, Paolo, Arroyo, Vincente, Fondevila, Constantino, Duvoux, Christophe, Jalan, Rajiv, Viganò, Raffaella, Mazzarelli, Chiara, Lauterio, Andrea, Giacomoni, Alessandro, Donato, Francesca, Lampertico, Pietro, Pasulo, Luisa, Fagiuoli, Stefano, Colledan, Michele, Cristina Morelli, Maria, Vitale, Giovanni, Ottobrelli, Antonio, Patrono, Damiano, Romagnoli, Renato, Petridis, Ioannis, Cillo, Umberto, Germani, Giacomo, Burra, Patrizia, Bachellier, Philippe, Schneider, Francis, Castelain, Vincent, Addeo, Pietro, Deridder, Mathilde, Caroline Sacleux Audrey Coilly, Sophie, Faouzi, Saliba, Adam, Rene, Samuel, Didier, Guichon, Celine, Faure, Stéfanie, Ursic‐Bedoya, Josè, Fondevila, Costantino, Colmenero, Jorde, Toapanta, David, Hernández‐Tejero, María, Vinaixa, Carmen, Polak, Wojciech G., den Hoed, Caroline, Haan, Jubi E., Della Penna, Andrea, Erhard Uschner, Frank, Welker, Martin, Zeuzem, Stefan, Bechstein, Wolf, Goossens, Nicolas, Raszeja‐Wyszomirska, Joanna, Rabinovich, Liane, Katarey, Dev, Agarwal, Banwari, Artzner, T, Bernal, W, Belli, L, Conti, S, Cortesi, P, Sacleux, S, Pageaux, G, Radenne, S, Trebicka, J, Fernandez, J, Perricone, G, Piano, S, Nadalin, S, Morelli, M, Martini, S, Polak, W, Zieniewicz, K, Toso, C, Berenguer, M, Iegri, C, Invernizzi, F, Volpes, R, Karam, V, Adam, R, Faitot, F, Rabinowich, L, Saliba, F, Meunier, L, Lesurtel, M, Uschner, F, Michard, B, Coilly, A, Meszaros, M, Poinsot, D, Besch, C, Schnitzbauer, A, De Carlis, L, Fumagalli, R, Angeli, P, Arroyo, V, Fondevila, C, Duvoux, C, Jalan, R, Viganò, R, Mazzarelli, C, Lauterio, A, Giacomoni, A, Donato, F, Lampertico, P, Pasulo, L, Fagiuoli, S, Colledan, M, Cristina Morelli, M, Vitale, G, Ottobrelli, A, Patrono, D, Romagnoli, R, Petridis, I, Cillo, U, Germani, G, Burra, P, Bachellier, P, Schneider, F, Castelain, V, Addeo, P, Deridder, M, Caroline Sacleux Audrey Coilly, S, Faouzi, S, Samuel, D, Guichon, C, Faure, S, Ursic‐bedoya, J, Colmenero, J, Toapanta, D, Hernández‐tejero, M, Vinaixa, C, den Hoed, C, Haan, J, Della Penna, A, Erhard Uschner, F, Welker, M, Zeuzem, S, Bechstein, W, Goossens, N, Raszeja‐wyszomirska, J, Rabinovich, L, Katarey, D, Agarwal, B, Artzner, Thierry, Bernal, William, Belli, Luca S, Conti, Sara, Cortesi, Paolo A, Sacleux, Sophie‐Caroline, Pageaux, George‐Philippe, Radenne, Sylvie, Trebicka, Jonel, Fernandez, Javier, Perricone, Giovanni, Piano, Salvatore, Nadalin, Silvio, Morelli, Maria C, Martini, Silvia, Polak, Wojciech G, Zieniewicz, Krzysztof, Toso, Christian, Berenguer, Marina, Iegri, Claudia, Invernizzi, Federica, Volpes, Riccardo, Karam, Vincent, Adam, René, Faitot, François, Rabinowich, Liane, Saliba, Faouzi, Meunier, Lucy, Lesurtel, Mickael, Uschner, Frank E, Michard, Baptiste, Coilly, Audrey, Meszaros, Magdalena, Poinsot, Domitille, Besch, Camille, Schnitzbauer, Andreas, De Carlis, Luciano G, Fumagalli, Roberto, Angeli, Paolo, Arroyo, Vincente, Fondevila, Constantino, Duvoux, Christophe, Jalan, Rajiv, Viganò, Raffaella, Mazzarelli, Chiara, Lauterio, Andrea, Giacomoni, Alessandro, Donato, Francesca, Lampertico, Pietro, Pasulo, Luisa, Fagiuoli, Stefano, Colledan, Michele, Cristina Morelli, Maria, Vitale, Giovanni, Ottobrelli, Antonio, Patrono, Damiano, Romagnoli, Renato, Petridis, Ioannis, Cillo, Umberto, Germani, Giacomo, Burra, Patrizia, Bachellier, Philippe, Schneider, Francis, Castelain, Vincent, Addeo, Pietro, Deridder, Mathilde, Caroline Sacleux Audrey Coilly, Sophie, Faouzi, Saliba, Adam, Rene, Samuel, Didier, Guichon, Celine, Faure, Stéfanie, Ursic‐Bedoya, Josè, Fondevila, Costantino, Colmenero, Jorde, Toapanta, David, Hernández‐Tejero, María, Vinaixa, Carmen, Polak, Wojciech G., den Hoed, Caroline, Haan, Jubi E., Della Penna, Andrea, Erhard Uschner, Frank, Welker, Martin, Zeuzem, Stefan, Bechstein, Wolf, Goossens, Nicolas, Raszeja‐Wyszomirska, Joanna, Rabinovich, Liane, Katarey, Dev, and Agarwal, Banwari

Abstract

Background: There is growing evidence that liver transplantation (LT) is the most effective treatment for acute-on-chronic liver failure grade-3 (ACLF-3). This study examines whether and how this evidence translates into practice by analyzing the variability in intensive care unit (ICU) admissions, listing strategies and LT activity for ACLF-3 patients across transplant centers in Europe. Methods: Consecutive patients who were admitted to the ICU with ACLF-3, whether or not they were listed and/or transplanted with ACLF-3 between 2018 and 2019 were included across 20 transplantation centers. Results: 351 patients with ACLF-3 were included: 33 had been listed prior to developing ACLF-3 and 318 had not been listed at the time of admission to the ICU. There was no correlation between the number of unlisted ACLF-3 patients admitted to the ICU and the number listed or transplanted whilst in ACLF-3 across centers. In contrast, there was a correlation between the number of patients listed and the number transplanted whilst in ACLF-3. 21% of patients who were listed whilst in ACLF-3 died on the waiting list or were delisted. The percentage of LT for ACLF-3 patients varied from 0%-29% of patients transplanted with decompensated cirrhosis across centers (average = 8%), with an I2 index of 68% (95% CI: 49%-80%), showing substantial heterogeneity among centers. The one-year survival for all patients with ACLF-3 was significantly higher in centers that listed and transplanted more ACLF-3 patients (>10 patients) than in centers that listed and transplanted fewer: respectively 36% vs. 20%, p = 0.012. Conclusion: Patients with ACLF-3 face inequity of access to LT across Europe. Wait-listing strategies for ACLF-3 patients influence their access to LT and, ultimately, their survival.

Published
2022

39. Heterogeneity of management practices surrounding operable gallbladder cancer - results of the OMEGA-S international HPB surgical survey

Author

Balakrishnan A, Jah A, Lesurtel M, Andersson B, Gibbs P, Harper SJF, Huguet EL, Kosmoliaptsis V, Liau SS, Praseedom RK, Ramia JM, Branes A, Lendoire J, Maithel S, and Serrablo A

Abstract

BACKGROUND: Gallbladder cancer (GBC) is an aggressive, uncommon malignancy, with variation in operative approaches adopted across centres and few large-scale studies to guide practice. We aimed to identify the extent of heterogeneity in GBC internationally to better inform the need for future multicentre studies. METHODS: A 34-question online survey was disseminated to members of the European-African Hepatopancreatobiliary Association (EAHPBA), American Hepatopancreatobiliary Association (AHPBA) and Asia-Pacific Hepatopancreatobiliary Association (A-PHPBA) regarding practices around diagnostic workup, operative approach, utilization of neoadjuvant and adjuvant therapies and surveillance strategies. RESULTS: Two hundred and three surgeons responded from 51 countries. High liver resection volume units (>50 resections/year) organised HPB multidisciplinary team discussion of GBCs more commonly than those with low volumes (p < 0.0001). Management practices exhibited areas of heterogeneity, particularly around operative extent. Contrary to consensus guidelines, anatomical liver resections were favoured over non-anatomical resections for T3 tumours and above, lymphadenectomy extent was lower than recommended, and a minority of respondents still routinely excised the common bile duct or port sites. CONCLUSION: Our findings suggest some similarities in the management of GBC internationally, but also specific areas of practice which differed from published guidelines. Transcontinental collaborative studies on GBC are necessary to establish evidence-based practice to minimise variation and optimise outcomes.

Published
2022

43. Duct-to-Duct Biliary Reconstruction with or without an Intraductal Removable Stent in Liver Transplantation: The BILIDRAIN-T Randomized Trial

Author

Goumard, C., primary, Boleslawski, E., additional, Brustia, R., additional, Dondero, F., additional, Herrero, A., additional, Lesurtel, M., additional, Barbier, L., additional, Lecolle, K., additional, Soubrane, O., additional, Bouyabrine, H., additional, Mabrut, J.Y., additional, Salamé, E., additional, Cachanado, M., additional, Simon, T., additional, and Scatton, O., additional

Published
2022
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