The difficulty of laparoscopic liver resection

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• 作者：Daisuke Ban ; Atsushi Kudo ; Hiromitsu Ito ; Yusuke Mitsunori…
• 关键词：Laparoscopic liver resection ; Laparoscopic hepatectomy ; Difficulty ; Complexity
• 刊名：Updates in Surgery
• 出版年：2015
• 出版时间：June 2015
• 年：2015
• 卷：67
• 期：2
• 页码：123-128
• 全文大小：1,454 KB
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• 作者单位：Daisuke Ban (1)
  Atsushi Kudo (1)
  Hiromitsu Ito (1)
  Yusuke Mitsunori (1)
  Satoshi Matsumura (1)
  Arihiro Aihara (1)
  Takanori Ochiai (1)
  Shinji Tanaka (2)
  Minoru Tanabe (1)
  Osamu Itano (3)
  Hironori Kaneko (4)
  Go Wakabayashi (5)
  
  1. Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
  2. Department of Molecular Oncology, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
  3. Department of Surgery, School of Medicine, Keio University, Tokyo, Japan
  4. Department of Surgery, Toho University Faculty of Medicine, Tokyo, Japan
  5. Department of Surgery, Ageo Central General Hospital, Saitama, Japan
  
• 刊物主题：Surgery;
• 出版者：Springer Milan
• ISSN：2038-3312

文摘

Grading of difficulty is needed for laparoscopic liver resection (LLR). Indications for LLR are expanding worldwide from minor to major resections, particularly in institutions having surgeons with advanced skills. If the degrees of surgical difficulty were defined, it would serve as a useful guide when introducing LLR and stepping up to the more advanced LLR. As no previous study has addressed the degrees of difficulty of various LLR procedures, we devised a practical scoring system for this purpose. We extracted the following five factors from preoperative information to score difficulty levels: (1) tumor location, (2) extent of liver resection, (3) tumor size, (4) proximity to major vessels, and (5) liver function. This difficulty index is comprised of the cumulative score for the five individual factors. There has not yet been a standard definition of difficulty. Our proposed scoring system might be a practical means of assessing the difficulty of LLR procedures. However, this system must be prospectively validated.