The Study On The Learning Curve Of Laparoscopic Liver Resection

Objective:1. to investigate the method to calculate the learning curve that more suitable for clinical condition; 2.to investigate the learning curve of laparoscopic left lateral segmentectomy and laparoscopic nonanatomic liver resection.Methods:the clinical data of patients who underwent laparoscopic left lateral sectionectomy from 2002 to 2012 and laparoscopic irregular liver resection from 2002 to 2014 were collected and reviewed. All of the operations were performed by the same surgical team. All patients were treated by the same surgical team, and cases with incomplete data were excluded. The patients were numbered according to the temporal order, and indexes including gender, age, Child-Pugh grade, operative duration, blood loss, conversion rate, postoperative hospital duration, rate of complications were analyzed. The statistical analysis included two steps:①a scatter plot of the standard deviation of the operative duration, blood loss, postoperative hospital duration was constructed respectively, and the group interval was determined according to the site of the peak;② the difference between the qualitative data (gender, Child-Pugh grade, rate of conversion, rate of postoperative complication) of the patients from different groups were analyzed using Pearson x2 analysis, and quantitative data (age, operative duration, blood loss, postoperative hospital duration) were analyzed using analysis of variance, with the post-hoc analysis performed according LSD method. All the analysis were performed using SPSS 20.0, and P<0.05 were considered as statistical significant.Result:The operative duration and blood loss of laparoscopic left lateral segmentectomy tend to be stable after 11 operations were finished; The postoperative hospital duration tend to be stable after 21 operations were finished; The operative duration and postoperative hospital duration of laparoscopic irregular hepatectomy tend to be stable after 30 operations were finished; The blood loss of laparoscopic irregular hepatectomy tend to be stable after 30 operations were finished.Conclusion:By calculating the standard deviation we could determine the group interval, which could be used in the clinical situration.