Evidence map›Paper›PMID 41838359›Full record

ArticleAnnals of surgical oncology2026

Conversion in Minimally Invasive Liver Surgery: The Impact of Conversion Urgency and Surgical Approach.

Gabriela Pilz da Cunha, Davit Aghayan, Federica Cipriani, Darren W Chua, Victoria Morrison-Jones, Jacopo Lanari, Celine de Meyere, Kongyuan Wei, Stylianos Tzedakis, John Martinie and 50 more

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Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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1 citing paper in PubMed.

  1. Article
4 · The record

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5 · Who and what money

Authors and funding

60 authors.

Gabriela Pilz da CunhaDepartment of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.
Davit AghayanThe Intervention Centre and Department of HPB Surgery, Oslo University Hospital and Institute of Medicine, University of Oslo, Oslo, Norway.
Federica CiprianiHepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy.
Darren W ChuaDepartment of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre, Singapore, Singapore.
Victoria Morrison-JonesDepartment of Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Jacopo LanariDepartment of Surgical, Oncological and Gastroenterological Sciences, General Surgery 2, Hepatopancreatobiliary Surgery and Liver Transplantation, Padua University Hospital, Padua, Italy.
Celine de MeyereDepartment of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, Kortrijk, Belgium.
Kongyuan WeiDepartment of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Stylianos TzedakisDepartment of Hepatobiliary, Digestive and Endocrine Surgery, Cochin hospital, AP-HP, Université Paris Cité, Inria, Inserm, HeKA, Paris, France.
John MartinieDivision of HPB Surgery, Department of Surgery, Carolinas Medical Center, Atrium Health, Charlotte, NC, USA.
Daniel Osei BordomLiver Unit, Queen Elizabeth Hospital, Birmingham, UK.
Soufyan El AdelDepartment of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.
Kaitlyn CrespoDigestive Health Institute, AdventHealth Tampa, Tampa, FL, USA.
Paolo MagistriHepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena, Italy.
Nadia RussolilloDepartment of General and Oncological Surgery, Umberto I Mauriziano Hospital, Turin, Italy.
Simone ConciDepartment of Surgery, University of Verona, Verona, Italy.
Andrea Benedetti CacciaguerraHepatobiliary and Abdominal Transplantation Surgery, Department of Experimental and Clinical Medicine, Riuniti Hospital, Polytechnic University of Marche, Ancona, Italy.
Daniel D'SouzaDepartment of Surgery, McMaster University, Hamilton, ON, Canada.
Gabriel ZozayaHPB and Liver Transplantation Unit, Department of Surgery, University Clinic, Universidad de Navarra, Institute of Health Research of Navarra (IdisNA), Pamplona, Spain.
Cèlia CaulaServei de Cirurgia General i Digestiva, Hospital Doctor Josep Trueta de Girona, Girona, Catalonia, Spain.
Shafiq RehmanDepartment of Surgery, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.
Åsmund Avdem FretlandThe Intervention Centre and Department of HPB Surgery, Oslo University Hospital and Institute of Medicine, University of Oslo, Oslo, Norway.
Ye-Xin KohDepartment of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre, Singapore, Singapore.
Marc G BesselinkzDepartment of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.
Susan van DierenDepartment of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.
David GellerDepartment of Surgery, Division of Hepatobiliary and Pancreatic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Ricardo Robles CamposDepartment of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de la Arrixaca, IMIB-ARRIXACA, El Palmar, Murcia, Spain.
Roland S CronerDepartment of General, Visceral, Vascular and Transplant Surgery, University Hospital Magdeburg, Magdeburg, Germany.
Elio JovineDepartment of Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Mikhail EfanovDepartment of Hepato-Pancreato-Biliary Surgery, Moscow Clinical Scientific Center, Moscow, Russia.
Adnan AlseidiDepartment of Surgery, Virginia Mason Medical Center, Seattle, WA, USA.
Riccardo MemeoHepato-Pancreato-Biliary Surgery Unit, Miulli Hospital, Acquaviva delle Fonti, Bari, Italy.
Ibrahim DagherDepartment of Hepatobiliary, Digestive and Endocrine Surgery, Cochin Hospital, Université Paris Cité, Paris, France.
Felice GiulianteHepato-Biliary Surgery Unit, Fondazione Policlinico Universitario A.Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Ernesto SparrelidDivision of Surgery and Oncology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Jawad AhmadUniversity Hospitals Coventry and Warwickshire, Coventry, UK.
Tom GallagherSt. Vincent's University Hospital, Dublin, Ireland.
Moritz SchmelzleHannover Medical School, Department of General, Visceral and Transplant Surgery, Hannover, Germany.
Steven WhiteDepartment of Surgery, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.
Santi Lopez BenServei de Cirurgia General i Digestiva, Hospital Doctor Josep Trueta de Girona, Girona, Catalonia, Spain.
Fernando RotellarHPB and Liver Transplantation Unit, Department of Surgery, University Clinic, Universidad de Navarra, Institute of Health Research of Navarra (IdisNA), Pamplona, Spain.
Pablo E SerranoDepartment of Surgery, McMaster University, Hamilton, ON, Canada.
Marco VivarelliHepatobiliary and Abdominal Transplantation Surgery, Department of Experimental and Clinical Medicine, Riuniti Hospital, Polytechnic University of Marche, Ancona, Italy.
Andrea RuzzenenteDepartment of Surgery, University of Verona, Verona, Italy.
Alessandro FerreroDepartment of General and Oncological Surgery, Umberto I Mauriziano Hospital, Turin, Italy.
Fabrizio Di BenedettoHepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena, Italy.
Iswanto SucandyDigestive Health Institute, AdventHealth Tampa, Tampa, FL, USA.
Robert P SutcliffeLiver Unit, Queen Elizabeth Hospital, Birmingham, UK.
Dionisios VrochidesDivision of Abdominal Transplantation, Department of Surgery, Carolinas Medical Center, Atrium Health, Charlotte, NC, USA.
David FuksDepartment of Digestive, Oncologic and Metabolic Surgery, Institut Mutualiste Montsouris, Université Paris Descartes, Paris, France.
Rong LiuFaculty of Hepatopancreatobiliary Surgery, The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
Mathieu D'HondtDepartment of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, Kortrijk, Belgium.
Umberto CilloDepartment of Surgical, Oncological and Gastroenterological Sciences, General Surgery 2, Hepatopancreatobiliary Surgery and Liver Transplantation, Padua University Hospital, Padua, Italy.
John N PrimroseDepartment of Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Brian K P GohDepartment of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre, Singapore, Singapore.
Francesca RattiHepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy.
Bjørn EdwinThe Intervention Centre and Department of HPB Surgery, Oslo University Hospital and Institute of Medicine, University of Oslo, Oslo, Norway.
Mohammad Abu Hilal *Department of Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK. abuhilal9@gmail.com.
Rutger-Jan Swijnenburg *Department of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands. r.j.swijnenburg@amsterdamumc.nl.
International Consortium on Minimally Invasive Liver Surgery (IMILS)

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundConversion to open surgery forfeits any potential benefits of minimally invasive liver surgery (MILS), however, it remains uncertain whether the conversion itself introduces additional risk. The impact may differ depending on urgency (emergency or elective) and surgical approach (robotic or laparoscopic liver resection). This study aimed to evaluate outcomes of emergency and elective conversions in robotic liver resection (RLR) and laparoscopic liver resection (LLR). PATIENTS AND

methodsData from 34 international centers of patients undergoing converted MILS procedures (stratified for conversion urgency) were retrospectively compared with patients who underwent elective open liver surgery using propensity score matching. Additionally, RLR and LLR conversions were compared. Conversion risk factors were identified using multivariable logistic regression in RLR and LLR separately.

resultsAmong 10,548 MILS procedures (n = 1626 RLR and n = 8922 LLR), 719 (6.8%) were converted. Both emergency (n = 226) and elective (n = 472) conversions were associated with longer operative time and more Pringle use compared with open surgery. Emergency conversions additionally showed higher blood loss, transfusion rates, severe morbidity, and even mortality. Matched analysis of 40 pairs of RLR and LLR conversions identified no significant differences in perioperative outcomes, although mortality following RLR conversion was remarkably high (7.7%). RLR conversion risk factors were bilobar disease and anatomically major resection; whereas LLR risk factors included cirrhosis, history of previous liver surgery, tumor size, technically complex, and anatomically major resection.

conclusionsEmergency conversions in MILS are associated with worse outcomes, whereas elective conversions appear safe, highlighting the importance of timely, controlled conversion. Further investigation into the safety of robotic conversions is warranted.

Indexed as

Conversion to Open SurgeryHepatectomyLaparoscopyLiver NeoplasmsMinimally Invasive Surgical ProceduresPostoperative ComplicationsRobotic Surgical ProceduresAgedBlood Loss, SurgicalElective Surgical ProceduresFemaleFollow-Up StudiesHumansMaleMiddle AgedOperative TimeConversionHepatectomyLaparoscopic liver surgeryMinimally invasive liver surgeryRobotic liver surgery

Identifiers

PMID41838359

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.