The value of analyzing textbook outcomes after laparoscopic hepatectomy—a narrative review

BACKGROUND AND OBJECTIVE: Guidelines are required because of the wide variability in care provided to patients with similar characteristics and similar medical conditions. Quality indicators were developed many years ago to assess the quality of care provided by hospitals. Since then, it has become evident that a composite set of factors can better characterize the patient’s quality of care. The objectives of this review were to analyze the textbook outcomes (TO) applied in surgery, focusing on laparoscopic hepatectomy. METHODS: Data pertaining to quality indicators used in hospitals and their surgical applications were retrieved from medical literature by searching PubMed and Google Scholar for articles published between 1912 and 2022. Search terms included quality indicators, outcome indicators, TOs, TOs after surgery, TOs after hepatectomy, and clinical indicators. KEY CONTENT AND FINDINGS: Since their inception, TO have been applied to various procedures and their impacts on patients have been assessed. TO and their implications have been studied for a variety of surgical procedures and were recently extended to laparoscopic hepatectomy. TO of laparoscopic left lateral sectionectomy and right hemihepatectomy were recently assessed, and benchmark values have been defined. TO are useful tools for assessing hospital performance and for optimizing the outcomes of patients undergoing laparoscopic hepatectomy. CONCLUSIONS: At present, TO only consider surgeon-related factors. However, it is important to include the patient’s perspective when defining TO. Although TO were recently applied to laparoscopic hepatectomy, there is still a need to further evaluate their application in this setting. Achieving TO was shown to have a positive impact on long-term outcomes and this needs to be studied for different liver resection procedures.