Validation of difficulty scoring system for laparoscopic liver resection in patients who underwent laparoscopic left lateral sectionectomy

Im, Chami; Cho, Jai Young; Han, Ho‐Seong; Yoon, Yoo Seok; Choi, Yo Won; Jang, Jae Yool; Choi, Hanlim; Jang, Jae Seong; Kwon, Sun U.

doi:10.1007/s00464-016-4994-7

Cited by 34 publications

(14 citation statements)

References 33 publications

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“…12 To date, only a few authors have used the DSS for comparative analysis of LLR results. 22 In our series, anatomic parenchymasparing resection of posterosuperior segments with vascular involvement proved to be the most complex procedure, according to the DSS.…”

Section: Discussionmentioning

confidence: 81%

Comparative analysis of learning curve in complex robot-assisted and laparoscopic liver resection

Ефанов

Alikhanov

Tsvirkun

et al. 2017

HPB

102

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Section: Discussionmentioning

confidence: 81%

Comparative analysis of learning curve in complex robot-assisted and laparoscopic liver resection

Ефанов

Alikhanov

Tsvirkun

et al. 2017

HPB

102

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“…Ban et al . 11 proposed the Iwate difficulty scoring system to assess the difficulty of LLR in 2014, and subsequent studies have validated this scoring system and confirmed its usefulness 12–15 . When the Iwate difficulty scoring system is used to classify patients into low-, intermediate-, and high-risk groups, the intraoperative blood loss volume and operation time reportedly significantly differ between the low- and high-risk groups and between the intermediate- and high-risk groups, but not between the low- and intermediate-risk groups 11 .…”

Section: Discussionmentioning

confidence: 97%

“…Ban et al . 11 introduced a difficulty scoring system to assess the difficulty of LLR, and some studies have validated this scoring system 12–15 . However, it is difficult to use the scoring system to evaluate the difficulty of LRH, as the system does not assess factors related to repeat hepatectomy.…”

Section: Introductionmentioning

confidence: 99%

Novel patient risk factors and validation of a difficulty scoring system in laparoscopic repeat hepatectomy

Okamura

Yamamoto

Sugiura

et al. 2019

Sci Rep

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The indications for laparoscopic liver resection have expanded; however, the safety and benefits of laparoscopic repeat hepatectomy (LRH) remain unclear. We retrospectively reviewed data from 137 patients who underwent partial hepatectomy or left lateral sectionectomy without thoracotomy. We compared patients’ clinical factors using a difficulty scoring system for LRH. We defined factors associated with blood loss volumes in the 75th percentile or above as risk factors for bleeding in open repeat hepatectomy, and determined whether these factors were useful for LRH risk assessment. Open repeat hepatectomy and LRH was performed in 96 and 41 patients, respectively. Four of 41 (9.8%) patients undergoing LRH were converted to laparotomy. Blood loss volume was significantly greater in the intermediate-risk group than in the low-risk group (P = 0.046). Multivariate analysis revealed that the presence of tumours located adjacent and caudal or dorsal to the primary tumour site was an independent risk factor for bleeding in LRH (odds ratio 3.21, 95% confidence interval 1.16–8.88, P = 0.024). Our study validated the usefulness of a difficulty scoring system, identified patient factors that predicted the difficulty of LRH, and presented a novel difficulty scoring system for LRH based on an existing difficulty scoring system.

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“…Factors affecting the difficulty include tumor location, tumor size, presence of cirrhosis, and proximity to major vessels. This grading system has been validated by several centers [97][98][99]. It is generally agreed that the system provides a good reflection of the complexity of the surgery.…”

Section: Hcc With Portal Vein Invasionmentioning

confidence: 99%

The Asia Pacific Consensus Statement on Laparoscopic Liver Resection for Hepatocellular Carcinoma: A Report from the 7th Asia-Pacific Primary Liver Cancer Expert Meeting Held in Hong Kong

et al. 2017

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Background: Laparoscopic liver resection has been gaining momentum, and it has become an accepted practice after the two international consensus conferences where experts worked up guidelines to standardize this approach and improve its safety. However, most laparoscopic hepatectomies were performed in patients with liver metastases. The concurrent presence of liver cirrhosis with hepatocellular carcinoma (HCC) poses a great challenge to clinicians trying to establish a routine use of laparoscopic liver resection for HCC. Summary: The first Asia Pacific consensus meeting on laparoscopic liver resection for HCC was held in July 2016 in Hong Kong. A group of expert liver surgeons with experience in both open and laparoscopic hepatectomy for HCC convened to formulate recommendations on the role and perspective of laparoscopic liver resection for primary liver cancer. The recommendations consolidate the most recent evidence pertaining to laparoscopic hepatectomy together with the latest thinking of practicing clinicians involved in laparoscopic hepatectomy, and give detailed guidance on how to deploy the treatment effectively for patients in need. Key Message: The panel of experts gathered evidence and produced recommendations providing guidance on the safe practice of laparoscopic hepatectomy for patients with HCC and cirrhosis. The inherent advantage of the laparoscopic approach may result in less blood loss if the procedure is performed in experienced centers. The laparoscopic approach to minor hepatectomy, particularly left lateral sectionectomy, is a preferred practice for HCC at experienced centers. Laparoscopic major liver resection for HCC remains a technically challenging operation, and it should be carried out in centers of excellence. There is emerging evidence that laparoscopic liver resection produces a better oncological outcome for HCC when compared with radiofrequency ablation, particularly when the lesions are peripherally located. Augmented features in laparoscopic liver resection, including indocyanine green fluorescence, 3D laparoscopy, and robot, will become important tools of surgical treatment in the near future. A combination of all of these features will enhance the experience of the surgeons, which may translate into better surgical outcomes. This is the first consensus workforce on laparoscopic liver resection for HCC, which is a unique condition that occurs in the Asia Pacific region.

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Validation of difficulty scoring system for laparoscopic liver resection in patients who underwent laparoscopic left lateral sectionectomy

Abstract: The surgical difficulty varies among patients undergoing the same laparoscopic LLS procedure. The modified DSS developed here can also be applied to patients with IHD stones.

Cited by 34 publications

References 33 publications

Comparative analysis of learning curve in complex robot-assisted and laparoscopic liver resection

Comparative analysis of learning curve in complex robot-assisted and laparoscopic liver resection

Novel patient risk factors and validation of a difficulty scoring system in laparoscopic repeat hepatectomy

The Asia Pacific Consensus Statement on Laparoscopic Liver Resection for Hepatocellular Carcinoma: A Report from the 7th Asia-Pacific Primary Liver Cancer Expert Meeting Held in Hong Kong

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