ArticleJournal of hepato-biliary-pancreatic sciences2014
A novel difficulty scoring system for laparoscopic liver resection.
Article in Journal of hepato-biliary-pancreatic sciences, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 274 papers, 4 of them syntheses that pooled it.
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Who cites it
274 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Robotic hepatectomy for benign liver disease: single-centre consecutive series and meta-analysis comparing minimally invasive and open approaches.Journal of robotic surgery · 2026Pooled it
- Updated overview of robotic hepatic parenchymal transection techniques: technical developments, international perspectives, and future directions.Journal of robotic surgery · 2026Pooled it
- Indocyanine green fluorescence navigation in robotic liver segmentectomies: a systematic review and meta-analysis.Journal of robotic surgery · 2025Pooled it
- Robotic Versus Laparoscopic Gastrectomy for Gastric Cancer: The Largest Systematic Reviews of 68,755 Patients and Meta-analysis.Annals of surgical oncology · 2025Pooled it
- Nomogram predicting surgical risk of laparoscopic left-sided hepatectomy for hepatolithiasis.Langenbeck's archives of surgery · 2023Trial
- Surgeon-perceived intraoperative complexity is associated with early adverse outcomes after major emergency abdominal surgery: a prospective cohort study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Impact of robotic approach on total operating room time and surgical workflow in minimally invasive liver resection (TAKUMI-8).Surgical endoscopy · 2026Article
- Automatic Generation of Liver Virtual Models With Artificial Intelligence: Application to Liver Resection Complexity Prediction.Annals of surgery · 2026Article
- From difficulty score to clinical outcome: Evaluating IWATE-criteria correlation with postoperative complications and revision surgery in anatomical liver resection.Annals of hepato-biliary-pancreatic surgery · 2026Article
- Textbook outcome after robotic liver surgery at a high-volume Scandinavian HPB center: an IWATE-based difficulty-stratified assessment of 200 cases.Surgical endoscopy · 2026Article
- Article
- Advanced robotic liver surgery.Surgical endoscopy · 2026Review
- Towards standardized assessment of surgical difficulty in robotic hepatobiliary surgery: a comparative validation study.Journal of robotic surgery · 2026Article
- Bona Fide Intersegmental Plane Hepatectomy Along the Glissonean Branches (BIPHG).Annals of gastroenterological surgery · 2026Review
- Definition and Classification of Minimally Invasive Major Hepatectomy (MIMH): A Literature Review and Expert Survey in the Fifth World Congress of the International Laparoscopic Liver Surgery (ILLS).Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2026Article
- Laparoscopic versus open partial hepatectomy for hepatocellular carcinoma in F4 cirrhosis: A propensity score-matched study of perioperative safety.Annals of hepato-biliary-pancreatic surgery · 2026Article
- Validation and applicability of the Tampa Difficulty Score for assessing procedural complexity in robotic liver surgery.Surgical endoscopy · 2026Article
- Benefits and risks of simultaneous versus staged laparoscopic resection for colorectal cancer with synchronous liver metastases.Surgery today · 2026Article
- Laparoscopic versus open liver resection for huge hepatocellular carcinoma (≥ than 10 cm): a multicenter propensity score-matched analysis from Eastern and Western referral centers.Surgical endoscopy · 2026Article
- Robotic Hepatectomy for Primary Liver Cancer.Annals of surgical oncology · 2026Review
214 more citing papers are in PubMed but not listed here.
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12 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Early on, laparoscopic liver resection (LLR) was limited to partial resection, but major LLR is no longer rare. A difficulty scoring system is required to guide surgeons in advancing from simple to highly technical laparoscopic resections. Subjects were 90 patients who had undergone pure LLR at three medical institutions (30 patients/institution) from January 2011 to April 2014. Surgical difficulty was assessed by the operator using an index of 1-10 with the following divisions: 1-3 low difficulty, 4-6 intermediate difficulty, and 7-10 high difficulty. Weighted kappa statistic was used to calculate the concordance between the operators' and reviewers' (expert surgeon) difficulty index. Inter-rater agreement (weighted kappa statistic) between the operators' and reviewers' assessments was 0.89 with the three-level difficulty index and 0.80 with the 10-level difficulty index. A 10-level difficulty index by linear modeling based on clinical information revealed a weighted kappa statistic of 0.72 and that scored by the extent of liver resection, tumor location, tumor size, liver function, and tumor proximity to major vessels revealed a weighted kappa statistic of 0.68. We proposed a new scoring system to predict difficulty of various LLRs preoperatively. The calculated score well reflected difficulty.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.