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首页> 外文期刊>Surgical Endoscopy >Validation of a difficulty scoring system for laparoscopic liver resection in hepatolithiasis
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Validation of a difficulty scoring system for laparoscopic liver resection in hepatolithiasis

机译：肝胆肝癌腹腔镜肝切除难度验证

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摘要

Background 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 previously developed to assess the difficulty of laparoscopic liver resection (LLR). Recently, we proposed a modified DSS for patients who undergo LLR for intrahepatic duct (IHD) stones. In this study, we validated the modified DSS for LLR for IHD stones. Methods We reviewed the clinical data of 121 patients who underwent LLR for IHD stones between July 2003 and November 2015 and validated the modified DSS in patients who underwent LLR according to their surgical outcomes. We divided the patients into subgroups according to their scores and compared the surgical outcomes, including hospital stay, operation time, blood loss, transfusion rate, and the postoperative complication rate and grade, among the subgroups of patients. Results The DSS score ranged from 3 to 12 in LLR for IHD stones. The operation time (P < 0.001) significantly increased according to the DSS score. The median hospital stay after surgery (P = 0.024) and transfusion rate (P = 0.001) were significantly different among subgroups of patients divided by their difficulty scores. When we divided the patients into two groups based on the side of liver of resected, the operation time (P < 0.001), mean difficulty score (P < 0.001), and blood loss (P = 0.041) were greater in patients who underwent right liver resection. Conclusions The surgical difficulty varies among patients undergoing the same LLR procedure for IHD stones. The modified DSS for IHD stones can effectively predict the surgery outcomes and complications of LLR.
机译：背景：以前开发了一种基于肝脏切除范围、肿瘤位置、肝功能、肿瘤大小和肿瘤与主要血管的接近程度的难度评分系统（DSS），用于评估腹腔镜肝脏切除（LLR）的难度。最近，我们为肝内胆管结石行LLR的患者提出了一种改良的DSS。在这项研究中，我们对IHD结石的LLR改良DSS进行了验证。方法我们回顾了2003年7月至2015年11月期间121例因IHD结石接受LLR治疗的患者的临床资料，并根据其手术结果验证了改良DSS在接受LLR治疗的患者中的有效性。我们根据评分将患者分为亚组，并比较亚组患者的手术结果，包括住院时间、手术时间、失血量、输血率、术后并发症发生率和等级。结果IHD结石的LLR DSS评分为3~12分。根据DSS评分，手术时间显著增加（P<0.001）。手术后住院时间中位数（P=0.024）和输血率（P=0.001）在按难度评分划分的患者亚组之间存在显著差异。当我们根据切除肝脏的一侧将患者分为两组时，右肝切除患者的手术时间（P<0.001）、平均难度评分（P<0.001）和出血量（P=0.041）更大。结论对于IHD结石进行相同LLR手术的患者，手术难度各不相同。改良的IHD结石DSS可有效预测LLR的手术结果和并发症。

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  • 来源
    《Surgical Endoscopy》 |2021年第3期|共8页
  • 作者

    Kim Jinju; Cho Jai Young; Han Ho-Seong; Yoon Yoo-Seok; Choi YoungRok; Lee Jun Suh; Lee Boram; Kim Junyub;

  • 作者单位

    Seoul Natl Univ Dept Surg Bundang Hosp 300 Gumi Dong Seongnam 463707 Gyeonggi South Korea;

    Seoul Natl Univ Dept Surg Bundang Hosp 300 Gumi Dong Seongnam 463707 Gyeonggi South Korea;

    Seoul Natl Univ Dept Surg Bundang Hosp 300 Gumi Dong Seongnam 463707 Gyeonggi South Korea;

    Seoul Natl Univ Dept Surg Bundang Hosp 300 Gumi Dong Seongnam 463707 Gyeonggi South Korea;

    Seoul Natl Univ Dept Surg Bundang Hosp 300 Gumi Dong Seongnam 463707 Gyeonggi South Korea;

    Seoul Natl Univ Dept Surg Bundang Hosp 300 Gumi Dong Seongnam 463707 Gyeonggi South Korea;

    Seoul Natl Univ Dept Surg Bundang Hosp 300 Gumi Dong Seongnam 463707 Gyeonggi South Korea;

    Seoul Natl Univ Dept Surg Bundang Hosp 300 Gumi Dong Seongnam 463707 Gyeonggi South Korea;

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  • 正文语种 eng
  • 中图分类 诊断学;
  • 关键词

    Outcome; Complication; Hepatectomy; Hepatolithiasis; Laparoscopy;

    机译：结果并发症肝切除术;肝结石;腹腔镜检查;

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