Abstract

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.

中文翻译：

---

腹腔镜肝切除术治疗肝结石的难度评分系统的验证

摘要

背景

先前已经开发了一种基于肝脏切除术的程度，肿瘤位置，肝功能，肿瘤大小以及肿瘤与主要血管的接近度的评分系统（DSS），以评估腹腔镜肝脏切除术（LLR）的难度。最近，我们为患有肝内导管（IHD）结石的LLR的患者提出了一种改良的DSS。在这项研究中，我们验证了用于IHD结石的LLR的改良DSS。

方法

我们回顾了2003年7月至2015年11月间接受ILR结石的LLR治疗的121例患者的临床数据，并根据手术结果验证了接受LLR治疗的患者的改良DSS。我们根据患者的得分将患者分为亚组，并比较患者亚组中的手术结局，包括住院时间，手术时间，失血量，输血率以及术后并发症发生率和等级。

结果

IHD结石的LLR的DSS评分范围为3到12。 根据DSS评分，手术时间（P <0.001）显着增加。 各亚组患者的手术后中位住院时间（P  = 0.024）和输血率（P = 0.001）之间存在显着差异（除以他们的难度评分）。当我们根据切除的肝侧将患者分为两组时 ，接受正确治疗的患者的手术时间（P  <0.001），平均困难评分（P  <0.001）和失血（P = 0.041）更大。肝切除。

结论

接受IHD结石的相同LLR手术的患者的手术难度各不相同。改良的IHD结石DSS可以有效预测LLR的手术结果和并发症。