ArticleSurgical endoscopy2020
Comparison and validation of three difficulty scoring systems in laparoscopic liver surgery: a retrospective analysis on 300 cases.
Article in Surgical endoscopy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Validation of the Institute Mutualiste Montsouris system for the stratification of laparoscopic liver resections: an international multicenter study.Hepatobiliary surgery and nutrition · 2026Article
- External validation of Tampa Difficulty Scoring System for robotic liver resection using Americas Minimally Invasive Liver Surgery Registry (AMILES).Surgical endoscopy · 2025Article
- Which technical difficulty score can best predict postoperative outcomes after minimally invasive liver resections?Langenbeck's archives of surgery · 2025Article
- Sub-classification of laparoscopic left hepatectomy based on hierarchic interaction of tumor location and size with perioperative outcomes.Journal of hepato-biliary-pancreatic sciences · 2023Article
- The difficulty grade of laparoscopic hepatectomy for hepatocellular carcinoma correlates with long-term outcomes.Updates in surgery · 2023Article
- A machine learning analysis of difficulty scoring systems for laparoscopic liver surgery.Surgical endoscopy · 2022Article
- Factors Influencing the Difficulty and Need for External Help during Laparoscopic Appendectomy: Analysis of 485 Procedures from the Resident-1 Multicentre Trial.Journal of personalized medicine · 2022Article
- Comparison of robotic and laparoscopic liver resection in ordinary cases of left lateral sectionectomy.Surgical endoscopy · 2022Article
- External validation of different difficulty scoring systems of laparoscopic liver resection for hepatocellular carcinoma.Surgical endoscopy · 2022Article
- Validation of the IWATE criteria as a laparoscopic liver resection difficulty score in a single North American cohort.Surgical endoscopy · 2022Article
- Impact of anthropometric data on technical difficulty of laparoscopic liver of resections of segments 7 and 8: the CHALLENGE index.Surgical endoscopy · 2021Article
- Factors that make Bariatric Surgery Technically Challenging: A Survey of 370 Bariatric Surgeons.World journal of surgery · 2021Article
- Robotic Resection of Postero-Superior Liver Segments (7,8) (with Video).Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- THERE ARE NO ADVANTAGES BETWEEN LAPAROSCOPIC AND OPEN LIVER RESECTIONS WITHIN AN ENHANCED RECOVERY PROGRAM (ERAS).Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2021Article
- First 100 minimally invasive liver resections in a new tertiary referral centre for liver surgery.Journal of minimal access surgeryArticle
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDifficulty scores (DSs) have been proposed to rate laparoscopic liver resection (LLR) technical difficulty increasing surgical safety. The aim of the study was to validate three DSs (Hasegawa, Halls and Kawaguchi) and compare their ability to predict technical difficulty and postoperative outcomes. MATERIALS AND
methodsAll patients who underwent LLR from January 2006 to January 2019 were analyzed. Exclusion criteria were cyst fenestrations, thermal ablation, missing data for the computation of the DS and a follow-up < 90 days.
resultsThe population comprised 300 patients. The DS distribution in the study population was: Halls low 55 (18.3%), moderate 82 (27.3%), high 111 (37%) and extremely high 52 (17.3%); Hasegawa low 130 (43.3%), medium 105 (35%) and high 65 (21.7%); Kawaguchi Grade I 194 (64.7%), Grade II 47 (15.7%) and Grade III 59 (19.7%). Hasegawa and Kawaguchi showed the strongest correlation (r = 0.798, p < 0.001). Technical complexity, evaluated using the Pringle maneuver, Pringle time, blood loss and operative time, increased significantly with Hasegawa and Kawaguchi score classes (p < 0.001 for all comparisons). None of the scores properly stratified postoperative complications. The highest Kawaguchi (23.7% grade III vs. 13.7% grades I and II, p = 0.057) and Hasegawa (24.6% high vs. 13.2% low/medium, p = 0.025) classes had a higher overall morbidity rate than medium-low ones.
conclusionsKawaguchi and Hasegawa scores predicted LLR's technical difficulty. None of the scores discriminated the postoperative complication risk of low classes compared with medium ones.
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