Article
Surgery
Jinju Kim, Jai Young Cho, Ho-Seong Han, Yoo-Seok Yoon, YoungRok Choi, Jun Suh Lee, Boram Lee, Junyub Kim
Summary: The study validated a modified difficulty scoring system for laparoscopic liver resection for intrahepatic duct stones, which effectively predicted surgical outcomes and complications. Surgical difficulty varied among patients, with significant differences in operation time, hospital stay, blood loss, transfusion rate, and postoperative complications based on difficulty scores. Patients who underwent right liver resection had longer operation time, higher difficulty score, and more blood loss compared to those who had left liver resection.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2021)
Article
Oncology
Cheng Xi, Maoqun Zhu, Tianhao Ji, Yulin Tan, Lin Zhuang, Zhiping Yuan, Zheng Zhang, Litian Xu, Zhilin Liu, Xuezhong Xu, Wenbo Xue, Wei Ding
Summary: A novel difficulty scoring system (NDSS) was developed to predict the surgical difficulty of laparoscopic hepatectomy. Patient characteristics, laboratory tests, intraoperative variables, and pathological characteristics were assessed. The NDSS was found to have a higher area under the receiver operating characteristic than the traditional scoring system, and a nomogram was established based on the NDSS for predicting the difficulty of liver resection surgery.
FRONTIERS IN ONCOLOGY
(2022)
Article
Surgery
Tao Liu, Yangyang Ou, Taiyun Huang, Zhaosong Xue, Ming Yao, Jianjun Li, Yubin Huang, Xiaoyong Cai, Yihe Yan
Summary: The low level of DSS-ER difficulty scoring system for laparoscopic liver resection (LLR) has been reclassified into three grades based on a retrospective analysis of 93 cases of LLRs for primary liver cancer. Significant differences were found among the different grades in terms of operative time, blood loss, intraoperative allogeneic blood transfusion, conversion to laparotomy, and allogeneic blood transfusion. However, there were no significant differences among the three grades in terms of postoperative biliary leakage and liver failure.
JOURNAL OF LAPAROENDOSCOPIC & ADVANCED SURGICAL TECHNIQUES
(2023)
Review
Surgery
Quentin Dubray, Sophie Laroche, Ecoline Tribillon, Brice Gayet, Marc Beaussier, Alexandra Nassar, Isabelle Aminot, Sandra Camps, David Fuks
Summary: LLR is a cost-effective procedure, with higher complexity leading to increased hospital costs. Clinical factors that significantly affect global charges include operating time, length of stay, admission in ICU, and occurrence of major complications, with ICU admission having the greatest impact on overall charges.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2021)
Article
Surgery
Theophile Guilbaud, Ugo Scemama, Anthony Sarran, Ecoline Tribillon, Alexandra Nassar, Brice Gayet, David Fuks
Summary: This study found that an estimated parenchymal transection surface area greater than or equal to 100 cm(2) is associated with surgical difficulty and postoperative complications in laparoscopic liver resection (LLR), including prolonged operative time, increased blood loss, higher conversion rate, and elevated risks of postoperative complications.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2021)
Article
Surgery
Haiping Lin, Yang Bai, Mengqiu Yin, Zewei Chen, Shian Yu
Summary: All four DSSs showed significant differences in predicting perioperative outcomes for LLR, with only the IWATE-DSS able to predict conversion rates for HCC patients. This DSS can also assist surgeons in choosing appropriate cases and guiding clinical practices during the LLR learning curve.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2022)
Article
Health Care Sciences & Services
Ruoh-Yun Gau, Ming-Chin Yu, Hsin- Tsai, Cheng-Han Lee, Tony Kuo, Kuan-Chieh Lee, Wei-Chen Lee, Kun-Ming Chan, Chien-Chih Chiu, Chao-Wei Lee
Summary: The study demonstrated that laparoscopic liver resection (LLR) for hepatocellular carcinoma (HCC) is feasible with favorable perioperative outcomes, suggesting that LLR should be the standard procedure for HCC with low or intermediate difficulty. While LLR tended to have lower complications and shorter hospital stays compared to conventional open liver resection (OLR), it showed comparable oncological outcomes in terms of disease-free survival (DFS) and overall survival. Further large-scale prospective studies are needed to validate these findings.
JOURNAL OF PERSONALIZED MEDICINE
(2021)
Article
Gastroenterology & Hepatology
Arpad Ivanecz, Irena Plahuta, Tomislav Magdalenic, Bojan Ilijevec, Matej Mencinger, Iztok Perus, Stojan Potrc
Summary: This study aimed to externally validate the Iwate scoring model's prognostic value for predicting intra- and postoperative complications of laparoscopic liver resection. The results showed that the model predicts complication probabilities across difficulty levels, and a new tumor size threshold (38 mm) was proposed to improve the prediction quality. The model was upgraded to provide a probability of complications for every difficulty score.
JOURNAL OF GASTROINTESTINAL SURGERY
(2021)
Article
Surgery
John O. Barron, Danny Orabi, Amika Moro, Cristiano Quintini, Eren Berber, Federico N. Aucejo, Kazunari Sasaki, Choon-Hyuck D. Kwon
Summary: This study validated the IWATE Criteria in a North American population, showing its correlation with operative time, EBL, and conversion to open surgery. The IWATE Criteria may help identify suitable LLR cases for surgeon experience and determine laparoscopic feasibility. Re-calibration of the difficulty score may be necessary as surgical perception of difficulty changes over time.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2022)
Article
Oncology
Arpad Ivanecz, Irena Plahuta, Matej Mencinger, Iztok Perus, Tomislav Magdalenic, Spela Turk, Stojan Potrc
Summary: This study quantitatively evaluated the learning curve of laparoscopic liver resection (LLR) of a single surgeon, showing both absolute and relative complexity in the mathematical description of the additive function. The learning curve indicates an ongoing learning process for LLR, with local extreme values until proficiency is achieved. This proposed mathematical model can be applied to surgical procedures with an existing difficulty score and predicted association between difficulty score and outcome.
RADIOLOGY AND ONCOLOGY
(2022)
Review
Gastroenterology & Hepatology
Yun-Le Linn, Andrew G. Wu, Ho-Seong Han, Rong Liu, Kuo-Hsin Chen, David Fuks, Olivier Soubrane, Daniel Cherqui, David Geller, Tan-To Cheung, Bjorn Edwin, Luca Aldrighetti, Mohammad Abu Hilal, Roberto Troisi, Go Wakabayashi, Brian K. P. Goh
Summary: This study reviewed the literature on difficulty scoring systems (DSS) for minimally invasive liver resection (MILR) and found that existing DSS are effective in predicting the difficulty of the surgery.
JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES
(2023)
Article
Medicine, General & Internal
Yeongsoo Jo, Jai Young Cho, Ho-Seong Han, Yoo-Seok Yoon, Hae Won Lee, Jun Suh Lee, Boram Lee, Eunhye Lee, Yeshong Park, MeeYoung Kang, Junghyun Lee
Summary: A novel difficulty scoring system (nDSS) was developed and validated in this study for predicting the surgical difficulty and outcomes of laparoscopic liver resection (LLR) for hepatolithiasis. The nDSS score was found to be significantly associated with the rates of red blood cell transfusion, postoperative hospital stay, and major complications. Patients in the high nDSS group had longer operation time, greater estimated blood loss, higher rates of red blood cell transfusion, longer postoperative hospital stay, and higher major complication rate compared to those in the low nDSS group.
MEDICINA-LITHUANIA
(2022)
Article
Surgery
Andrea Ruzzenente, Fabio Bagante, Edoardo Poletto, Tommaso Campagnaro, Simone Conci, Mario De Bellis, Corrado Pedrazzani, Alfredo Guglielmi
Summary: This study investigated the predictive ability of four difficulty scoring systems (DSS) for laparoscopic liver resections (LLR) and found that Kawaguchi and Iwate DSS performed the best in predicting operative outcomes, while Halls score was the most important variable in predicting textbook outcome.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2022)
Article
Surgery
Sung Hoon Choi, Kuo-Hsin Chen, Nicholas L. Syn, Federica Cipriani, Tan-To Cheung, Adrian K. H. Chiow, Gi-Hong Choi, Tiing-Foong Siow, Iswanto Sucandy, Marco Marino, Mikel Gastaca, Charing C. Chong, Jae Hoon Lee, Arpad Ivanecz, Vincenzo Mazzaferro, Santiago Lopez-Ben, Constantino Fondevila, Fernando Rotellar, Ricardo Robles Campos, Mikhail Efanov, T. Peter Kingham, Robert P. Sutcliffe, Roberto Troisi, Johann Pratschke, Xiaoying Wang, Mathieu D'Hondt, Chee Chien Yong, Giovanni Battista Levi Sandri, Chung Ngai Tang, Andrea Ruzzenente, Daniel Cherqui, Alessandro Ferrero, Go Wakabayashi, Olivier Scatton, Davit Aghayan, Bjorn Edwin, Fabricio Ferreira Coelho, Felice Giuliante, Rong Liu, Jasper Sijberden, Mohammad Abu Hilal, Atsushi Sugioka, Tran Cong Duy Long, David Fuks, Luca Aldrighetti, Ho-Seong Han, Brian K. P. Goh
Summary: This study validated the utility of the Iwate Score (IS) for right posterior sectionectomy (RPS) and found that it did not significantly correlate with surgical difficulty and postoperative outcomes. The location of the tumor also had no effect on RPS outcomes.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2022)
Article
Oncology
Tousif Kabir, Nicholas Syn, Ye-Xin Koh, Jin-Yao Teo, Alexander Y. Chung, Chung-Yip Chan, Brian K. P. Goh
Summary: This study aimed to investigate the impact of tumour size on the difficulty of MILR and determine the optimal tumour size cut-off to distinguish between easy and difficult MILRs. The results showed that patients with larger tumours had longer operating times, higher blood loss, and longer hospital stay. There was also an increasing trend in blood transfusion rates, overall morbidity, and 90-day mortality rates with increasing tumour size.