Authors: Chami Im Jai Young Cho HoSeong Han YooSeok Yoon YoungRok Choi Jae Yool Jang Hanlim Choi Jae Seong Jang Seong Uk Kwon
Publish Date: 2016/06/10
Volume: 31, Issue: 1, Pages: 430-436
Abstract
A difficulty scoring system DSS based on the extent of liver resection tumor location liver function tumor size and tumor proximity to major vessels was recently developed to assess the difficulty of various laparoscopic liver resection procedures We validated DSS in patients who underwent laparoscopic left lateral sectionectomy LLSWe reviewed the clinical data of 124 patients who underwent laparoscopic LLS between July 2003 and November 2015 and validated the DSS in 90 patients who underwent laparoscopic LLS for tumor according to their surgical outcomes We also developed and evaluated the modified DSS in 34 patients who underwent LLS for intrahepatic duct IHD stonesThe DSS score ranged from 3 to 6 in laparoscopic LLS for tumors The median blood loss P = 0002 was significantly different among patients divided into subgroups by DSS score We made modified DSS for IHD stones using factors influencing longer operation time including stone location P = 0002 atrophy of liver parenchyma P = 0012 ductal stricture 1 cm from the bifurcation P = 0047 and combined choledochoscopic examination for remnant IHD P 0001 The modified DSS score for IHD stones ranged from 3 to 7 Blood loss P = 002 and operation time P 0001 were significantly different among subgroups of patients divided by their difficulty scores The median hospital stay P = 0004 and operation time P = 0039 were significantly longer and the complication rate P = 0025 and complication grade P = 0021 were significantly greater in patients with IHD stones than in patients with tumors
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