The Study On The Learning Curve Of Laparoscopic Left Lateral Liver Resection

Objective:To explore the learning curve of laparoscopic left lateral liver resection in our center.Methods:We collected and analysed the clinical data of patients who underwent lapascopic left lateral liver resection from 1999 Jun to 2016 Aug in the Zhejiang University Medical College Affiliated Sir Run Run Shaw hospital.A total of 169 laparoscopic left lateral liver resection were included.All of the operations were performed by the same surgical team,and the patients were numbered according to the temporal order.All experimental data include gender,age,history of upper abdominal surgery,hepatitis B infection,liver cirrhosis,preoperative liver function,coagulation function,Child-Pugh classification and ASA score,then we collected operation time,blood loss,whether the need of hand assistance,the conversion to open surgery,the use of pringle,intraoperative transfusions,postoperative complications,length of postoperative stay and so on.The CUSUM technique were used to process operation time and blood loss,then the original data was converted to the the cumulative sum.From the Scatter plot of the the cumulative sum,we could concludethat the peak value of the cumulative sum represents the starting point for the data to be stable.On this peak value,the patients were divided into early and late groups.Statistical analysis was performed using SPSS 20 statistical software,and compared the two groups in operation time,blood loss,whether the need of hand assistance,the conversion to open surgery,the use of pringle,intraoperative transfusions,postoperative complications,length of postoperative stay.P<0.05 was considered as statistically significant.Results:The learning curve of operation time for laparoscopic left lateral liver resection showed a stable period after the completion of 33 patients of aparoscopic left lateral liver resection,and the operation time and blood loss were also statistically significant.The learning curve of blood loss showed a stable period after the completion of 35 patients of laparoscopic left lateral liver resection,and the operation time and blood loss were also statistically significantConclusion:We conclude that the learning curve of laparoscopic left lateral liver resection in our center is about 33 to 35 cases,Because of the relatively simple and easy to learn laparoscopic left lateral liver resection,it is a safe and feasible method for surgeons who have undergone laparoscopic surgery.