Prediction of surgical outcomes of laparoscopic liver resections for hepatocellular carcinoma by defining surgical difficulty

Surgical Endoscopy
Mohan PeriyasamyHanisah Guro

Abstract

Several classification systems for assessing the surgical difficulty of laparoscopic liver resection (LLR) have been proposed. We evaluated three current classification systems, including traditional Major/Minor Classification, Complexity Classification, and the Difficulty Scoring System for predicting the surgical outcomes after LLR. We reviewed the clinical data of 301 patients who underwent LLR for hepatocellular carcinoma between March 1, 2004 and June 30, 2015. We compared the intraoperative, pathologic, and postoperative outcomes according to the three classifications. We also compared the prognostic value of the three classifications using receiver operating characteristic (ROC) curves. The Major/Minor Classification, Complexity Classification, and the Difficulty Scoring System efficiently differentiated surgical difficulty in terms of blood loss (P = 0.001, P = 0.009, and P < 0.001, respectively) and operation time (all P < 0.001). Regarding intraoperative outcomes, the Difficulty Scoring System and Complexity Classification successfully differentiated the transfusion rate (P = 0.001 and P < 0.001, respectively). However, only the Complexity Classification adequately predicted severe postoperative complications (P = 0.0...Continue Reading

References

Nov 17, 2009·Annals of Surgery·Joseph F BuellUNKNOWN World Consensus Conference on Laparoscopic Surgery
Jun 22, 2011·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Srinevas K ReddyBryan M Clary
Sep 23, 2014·Journal of Hepato-biliary-pancreatic Sciences·Daisuke BanGo Wakabayashi
Jul 15, 2015·Updates in Surgery·Daisuke BanGo Wakabayashi
Apr 14, 2016·Journal of the American College of Surgeons·Major K LeeSteven M Strasberg
Jun 16, 2016·Clinical and Molecular Hepatology·Hanisah GuroMohan Periyasamy

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Citations

May 10, 2018·Annals of Surgery·Yoshikuni KawaguchiBrice Gayet
Jun 5, 2020·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Arpad IvaneczStojan Potrč
Oct 8, 2020·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Brian K P GohChung-Yip Chan

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