Abstract
Purpose
The aim of this retrospective study was to evaluate a revised classification system for predicting the difficulty of laparoscopic partial liver resection.
Methods
Patients who had undergone initial laparoscopic partial liver resection for a solitary lesion from January 2012 to February 2021were classified into two groups according to the type of procedure performed, “scooping-out” versus “cutting.” The participants were then further divided into “small” and “large” subgroups according to the tumor’s depth and diameter. Finally, they were categorized into two groups, namely “standard” and “advanced.” Operative outcomes were compared between the two groups and the proposed revised system for classifying difficulty of laparoscopic partial liver resection compared with the existing scoring system.
Results
Of the 65 procedures assessed, 40 were categorized as standard and 25 as advanced. Tumor size (P < 0.001), operation time (P < 0.001), volume of intraoperative blood loss (P = 0.001), rate of the Pringle maneuver (P = 0.044), and resected liver weight (P < 0.001) were significantly greater in the advanced than in the standard group. Differences in operation time and intraoperative blood loss were not identified by the existing difficulty scoring system.
Conclusion
The proposed revised classification is useful for predicting the difficulty of laparoscopic partial liver resection.
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Data availability
The dataset analyzed for the current study is available from the corresponding author on reasonable request.
Code availability
Not applicable.
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Acknowledgements
We thank Dr. Trish Reynolds, MBBS, FRACP, from Edanz (http://jp.edanz.com/ac), for editing the English text of a draft of this manuscript.
Funding
This study was supported by JSPS KAKENHI (Grant Number 21K15515).
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Authors and Affiliations
Contributions
Study conception and design: Onda S. Acquisition of data: Onda S, Furukawa K, Haruki K, Shirai Y, Hamura R, Yasuda J, Shiozaki H, Gocho T, Shiba H. Analysis and interpretation of data: Furukawa K, Haruki K, Shirai Y. Drafting of manuscript: Onda S. Critical revision of manuscript: Ikegami T.
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Ethics approval
The study met the ethical standards of the World Medical Association Declaration of Helsinki and its protocol was approved by the Ethics Committee of the Jikei University School of Medicine (27-177[8062]).
Conflict of interest
The authors declare no competing interests.
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Written informed consent was obtained from each patient for their surgical procedures.
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Onda, S., Furukawa, K., Haruki, K. et al. Proposal for a revised system for classifying difficulty of laparoscopic partial liver resection. Langenbecks Arch Surg 406, 1533–1541 (2021). https://doi.org/10.1007/s00423-021-02253-2
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DOI: https://doi.org/10.1007/s00423-021-02253-2