Uchida Hiroki, Iwashita Yukio, Saga Kunihiro, Takayama Hiroomi, Watanabe Kiminori, Endo Yuichi, Yada Kazuhiro, Ohta Masayuki, Inomata Masafumi
Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine , Oita, Japan .
J Laparoendosc Adv Surg Tech A. 2016 Sep;26(9):702-6. doi: 10.1089/lap.2016.0135. Epub 2016 Jun 28.
Laparoscopic liver resection (LLR) has several problems, such as technical complexity and patient and tumor factors. A difficulty scoring system to preoperatively evaluate the difficulty of LLR was established at the second International Consensus Conference on Laparoscopic Liver Resection. The aim of this study was to explore the clinical usefulness of the difficulty scoring system for LLR.
From January 2010 to June 2015, the records of 78 patients who had undergone LLR were retrospectively reviewed. The patients' data were used to assign a difficulty score, and the correlations between scores and surgical outcomes were investigated.
The mean surgical time was 256 minutes, and the mean blood loss was 168 mL. The difficulty score significantly correlated with surgical time and blood loss, but not with morbidity and postoperative hospital stay. Multivariate analysis showed that the difficulty score was an independent predictor of prolonged surgical time.
The difficulty score was found to be an effective predictor of surgical time for LLR.
腹腔镜肝切除术（LLR）存在若干问题，如技术复杂性以及患者和肿瘤因素。在第二届腹腔镜肝切除术国际共识会议上建立了一个术前评估LLR难度的困难评分系统。本研究的目的是探讨该LLR困难评分系统的临床实用性。
回顾性分析2010年1月至2015年6月期间78例行LLR患者的病历。利用患者数据确定困难评分，并研究评分与手术结果之间的相关性。
平均手术时间为256分钟，平均失血量为168毫升。困难评分与手术时间和失血量显著相关，但与发病率和术后住院时间无关。多因素分析显示，困难评分是手术时间延长的独立预测因素。
发现困难评分是LLR手术时间的有效预测指标。
