ArticleJournal of hepato-biliary-pancreatic sciences2021
Assessment of difficulty in laparoscopic distal pancreatectomy: A modification of the Japanese difficulty scoring system - A single-center high-volume experience.
Article in Journal of hepato-biliary-pancreatic sciences, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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14 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Robotic versus laparoscopic distal pancreatectomy on perioperative outcomes: a systematic review and meta-analysis.Updates in surgery · 2023Pooled it
- Pancreatic ductal adenocarcinoma and pancreatic surgery in the 21st century: triumphs, turning points, and unresolved challenges.Updates in surgery · 2026Review
- Surgical Outcomes of Sequential Robot-Assisted Hepatobiliary-Pancreatic Surgery in a Single Operating Room: A Single-Center Retrospective Analysis of a High-Volume Center in Japan (TAKUMI-6).Annals of gastroenterological surgery · 2026Article
- A risk-based framework to support conversion decision-making during minimally invasive left pancreatectomy: results from a multicentre registry.Updates in surgery · 2026Article
- When should the robot step aside?-conversion in robotic distal pancreatectomy: lessons from an international multicenter study.Gland surgery · 2026Article
- Impact of preoperative biliary drainage on surgical risk in pancreaticoduodenectomy for resectable periampullary tumors.Translational gastroenterology and hepatology · 2026Article
- What factors are associated with robotic distal pancreatectomy conversion?Gland surgery · 2025Article
- Predicting operative complexity in laparoscopic splenectomy: a validated preoperative scoring system.Surgical endoscopy · 2025Article
- Impact of visceral fat area on surgical difficulty during robotic distal pancreatectomy (TAKUMI-2).Surgical endoscopy · 2025Article
- Practical implications of tumor proximity to landmark vessels in minimally invasive radical antegrade modular pancreatosplenectomy.Updates in surgery · 2023Article
- Identifying the preoperative factors predicting the surgical difficulty of robotic distal pancreatectomy.Surgical endoscopy · 2023Article
- Development of artificial blood loss and duration of excision score to evaluate surgical difficulty of total laparoscopic anterior resection in rectal cancer.Frontiers in oncology · 2023Article
- Optimal lymph-node dissection for pancreatic tail cancer.Surgery today · 2022Article
- Assessment of difficulty in laparoscopic distal pancreatectomy: A modification of the Japanese difficulty scoring system - A single-center high-volume experience.Journal of hepato-biliary-pancreatic sciences · 2021Article
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10 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Japanese difficulty scoring system (DSS) was developed to assess the difficulty of laparoscopic distal pancreatectomy (LDP). The study aimed to validate a modified DSS (mDSS) in a European high-volume center.
methodsPatients' clinical data underwent LDP for benign and malignant pancreatic lesion between September 2013 and February 2020 were reviewed. Expert laparoscopic surgeons performed the procedures. The mDSS consisted of seven variables, such as type of operation, malignancy, neoadjuvant therapy, pancreatic resection line, tumor close to major vessels, tumor extension to peripancreatic tissue, and left-sided portal hypertension and/or splenomegaly. According to the difficulty level and previous score, the mDSS was subdivided into three classes: low, intermediate, and high. Surrogates of case complexity (operative time, intraoperative blood loss and blood transfusion requirements, conversion rate) were used to validate the new scoring system.
resultsThe study population included 140 LDP. Ninety-five (68%), 35 (25%) and 10 (7%) patients belonged to low, intermediate, and high difficulty groups. The mDSS identified the complexity of the surgical case of the series for all the surrogates of complexity considered, namely conversion rate (P = .004), operative time (P = .033) and intraoperative blood loss (P = .009). No differences were recorded in the postoperative outcomes (P > .05).
conclusionThe mDSS for LDP better stratified the pancreatic procedures according to their complexity. The new scoring system may allow an appropriate preoperative evaluation of surgical difficulty, facilitating LDP's training program. Future prospective studies are needed to validate the mDSS.
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