Skip to main content
SpringerLink
Log in

The preoperative M2BPGi score predicts operative difficulty and the incidence of postoperative complications in laparoscopic liver resection

  • Original Article
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Liver fibrosis or cirrhosis frequently makes parenchymal transection more difficult, but the difficulty score of laparoscopic liver resection (LLR), including the IWATE criteria, does not include a factor related to liver fibrosis. Therefore, this study aimed to evaluate M2BPGi as a predictor of the difficulty of parenchymal transection and the incidence of postoperative complications in LLR.

Methods

Data from 54 patients who underwent laparoscopic partial liver resection (LLR-P) and 24 patients who underwent laparoscopic anatomical liver resection between 2017 and 2019 in our institution were retrospectively analyzed. All cases were classified according to M2BPGi scores, and reserve liver function, intraoperative blood loss, and postoperative complications were compared among these groups.

Results

Sixteen cases (29.6%) were M2BPGi negative (cut-off index < 1.0), 25 cases (46.3%) were 1+ (1.0 ≤ cut-off index < 3.0), and 13 cases (24.1%) were 2+ (cut-off index ≥ 3.0). M2BPGi-positive cases had significantly worse hepatic reserve function (K-ICG: 0.16 vs 0.14 vs 0.08, p < 0.0001). Intraoperative bleeding was significantly greater in M2BPGi-positive cases [50 ml vs 150 ml vs 200 ml, M2BPGi (−) or (1+) vs M2BPGi (2+), p = 0.045]. Postoperative complications (Clavien–Dindo ≥ II) were significantly more frequent in M2BPGi-positive cases [0% vs 4% vs 33%, M2BPGi (−) or (1+) vs M2BPGi (2+), p = 0.001].

Conclusion

M2BPGi could predict surgical difficulty and complications in LLR-P. In particular, it might be better not to select M2BPGi (2+) cases as teaching cases because of the massive bleeding during parenchymal transection.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Hibi T, Cherqui D, Geller DA, Itano O, Kitagawa Y, Wakabayashi G (2014) International survey on technical aspects of laparoscopic liver resection: a web-based study on the global diffusion of laparoscopic liver surgery prior to the 2nd international consensus conference on laparoscopic liver resection in Iwate, Japan. J Hepatobiliary Pancreat Sci 21:7377–7344

    Article  Google Scholar 

  2. Buell JF, Cherqui D, Geller DA, O’Rourke N, Iannitti D, Dagher I, Koffron AJ, Thomas M, Gayet B, Han HS, Wakabayashi G, Belli G, Kaneko H, Ker CG, Scatton O, Laurent A, Abdalla EK, Chaudhury P, Dutson E, Gamblin C, D’Angelica M, Nagorney D, Testa G, Labow D, Manas D, Poon RT, Nelson H, Martin R, Clary B, Pinson WC, Martinie J, Vauthey JN, Goldstein R, Roayaie S, Barlet D, Espat J, Abecassis M, Rees M, Fong Y, McMasters KM, Broelsch C, Busuttil R, Belghiti J, Strasberg S, Chari RS, World Consensus Conference on Laparoscopic Surgery (2009) The international position on laparoscopic liver surgery: the Louisville statement, 2008. Ann Surg 250:825–830

    Article  PubMed  Google Scholar 

  3. Wakabayashi G, Cherqui D, Geller DA, Buell JF, Kaneko H, Han HS, Asbun H, O’Rourke N, Tanabe M, Koffron AJ, Tsung A, Soubrane O, Machado MA, Gayet B, Troisi RI, Pessaux P, Van Dam RM, Scatton O, Abu Hilal M, Belli G, Kwon CH, Edwin B, Choi GH, Aldrighetti LA, Cai X, Cleary S, Chen KH, Schön MR, Sugioka A, Tang CN, Herman P, Pekolj J, Chen XP, Dagher I, Jarnagin W, Yamamoto M, Strong R, Jagannath P, Lo CM, Clavien PA, Kokudo N, Barkun J, Strasberg SM (2015) Recommendations for laparoscopic liver resection: a report from the second international consensus conference held in Morioka. Ann Surg 261(4):619–629

    PubMed  Google Scholar 

  4. Ban D, Tanabe M, Kumamaru H, Nitta H, Otsuka Y, Miyata H, Kakeji Y, Kitagawa Y, Kaneko H, Wakabayashi G, Yamaue H, Yamamoto M (2021) Safe dissemination of laparoscopic liver resection in 27,146 cases between 2011 and 2017 from the national clinical database of Japan. Ann Surg 274(6):1043–1050

    Article  PubMed  Google Scholar 

  5. Nguyen KT, Gamblin TC, Geller DA (2009) World review of laparoscopic liver resection-2,804 patients. Ann Surg 250(5):831–841

    Article  PubMed  Google Scholar 

  6. Cheung TT, Han HS, She WH, Chen KH, Chow PKH, Yoong BK, Lee KF, Kubo S, Tang CN, Wakabayashi G (2018) The Asia Pacific consensus statement on laparoscopic liver resection for hepatocellular carcinoma: a report from the 7th Asia-Pacific primary liver cancer expert meeting held in Hong Kong. Liver Cancer 7(1):28–39

    Article  PubMed  Google Scholar 

  7. Ban D, Tanabe M, Ito H, Otsuka Y, Nitta H, Abe Y, Hasegawa Y, Katagiri T, Takagi C, Itano O, Kaneko H, Wakabayashi G (2014) A novel difficulty scoring system for laparoscopic liver resection. J Hepatobiliary Pancreat Sci 21(10):745–753

    Article  PubMed  Google Scholar 

  8. Wakabayashi G (2016) What has changed after the Morioka consensus conference 2014 on laparoscopic liver resection? Hepatobiliary Surg Nutr 5(4):281–289

    Article  PubMed  PubMed Central  Google Scholar 

  9. Tanaka S, Kawaguchi Y, Kubo S, Kanazawa A, Takeda Y, Hirokawa F, Nitta H, Nakajima T, Kaizu T, Kaibori M, Kojima T, Otsuka Y, Fuks D, Hasegawa K, Kokudo N, Kaneko H, Gayet B, Wakabayashi G (2019) Validation of index-based IWATE criteria as an improved difficulty scoring system for laparoscopic liver resection. Surgery 165(4):731–740

    Article  PubMed  Google Scholar 

  10. Belli G, Fantini C, D’Agostino A, Cioffi L, Langella S, Russolillo N, Belli A (2007) Laparoscopic versus open liver resection for hepatocellular carcinoma in patients with histologically proven cirrhosis: short- and middle-term results. Surg Endosc 21(11):2004–2011

    Article  CAS  PubMed  Google Scholar 

  11. Belli G, Fantini C, Belli A, Limongelli P (2011) Laparoscopic liver resection for hepatocellular carcinoma in cirrhosis: long-term outcomes. Dig Surg 28:134–140

    Article  PubMed  Google Scholar 

  12. Beard RE, Wang Y, Khan S, Marsh JW, Tsung A, Geller DA (2018) Laparoscopic liver resection for hepatocellular carcinoma in early and advanced cirrhosis. HPB (Oxford) 20(6):521–529

    Article  PubMed  Google Scholar 

  13. Troisi RI, Berardi G, Morise Z, Cipriani F, Ariizumi S, Sposito C, Panetta V, Simonelli I, Kim S, Goh BKP, Kubo S, Tanaka S, Takeda Y, Ettorre GM, Russolillo N, Wilson GC, Cimino M, Montalti R, Giglio MC, Igarashi K, Chan CY, Torzilli G, Cheung TT, Mazzaferro V, Kaneko H, Ferrero A, Geller DA, Han HS, Kanazawa A, Wakabayashi G, Aldrighetti L, Yamamoto M (2021) Laparoscopic and open liver resection for hepatocellular carcinoma with Child-Pugh B cirrhosis: multicentre propensity score-matched study. Br J Surg 108(2):196–204

    Article  CAS  PubMed  Google Scholar 

  14. Le Roux F, Rebibo L, Cosse C, Chatelain D, Nguyen-Khac E, Badaoui R, Regimbeau JM (2018) Benefits of laparoscopic approach for resection of liver tumors in cirrhotic patients. J Laparoendosc Adv Surg Tech A 28(5):553–561

    Article  PubMed  Google Scholar 

  15. Hobeika C, Fuks D, Cauchy F, Goumard C, Soubrane O, Gayet B, Salamé E, Cherqui D, Vibert E, Scatton O, AFC-LLR-2018 study group, Nomi T, Oudafal N, Kawai T, Komatsu S, Okumura S, Petrucciani N, Laurent A, Bucur P, Barbier L, Trechot B, Nunèz J, Tedeschi M, Allard MA, Golse N, Ciacio O, Pittau G, Cunha AS, Adam R, Laurent C, Chiche L, Leourier P, Rebibo L, Regimbeau JM, Ferre L, Souche FR, Chauvat J, Fabre JM, Jehaes F, Mohkam K, Lesurtel M, Ducerf C, Mabrut JY, Hor T, Paye F, Balladur P, Suc B, Muscari F, Millet G, El Amrani M, Ratajczak C, Lecolle K, Boleslawski E, Truant S, Pruvot FR, Kianmanesh AR, Codjia T, Schwarz L, Girard E, Abba J, Letoublon C, Chirica M, Carmelo A, VanBrugghe C, Cherkaoui Z, Unterteiner X, Memeo R, Pessaux P, Buc E, Lermite E, Barbieux J, Bougard M, Marchese U, Ewald J, Turini O, Thobie A, Menahem B, Mulliri A, Lubrano J, Zemour J, Fagot H, Passot G, Gregoire E, Hardwigsen J, le Treut YP, Patrice D (2020) Impact of cirrhosis in patients undergoing laparoscopic liver resection in a nationwide multicentre survey. Br J Surg 107(3):268–277

    Article  CAS  PubMed  Google Scholar 

  16. Goh BKP, Syn N, Lee SY, Koh YX, Teo JY, Kam JH, Cheow PC, Jeyaraj PR, Chow PK, Ooi LL, Chung AY, Chan CY (2021) Impact of liver cirrhosis on the difficulty of minimally-invasive liver resections: a 1:1 coarsened exact-matched controlled study. Surg Endosc 35(9):5231–5238

    Article  PubMed  Google Scholar 

  17. Shen Y, Shi G, Huang C, Zhu X, Chen S, Sun H, Zhou J, Fan J (2015) Prediction of post-operative liver dysfunction by serum markers of liver fibrosis in hepatocellular carcinoma. PLoS ONE 10(10):e0140932

    Article  PubMed  PubMed Central  Google Scholar 

  18. Liu J, Hu HH, Lee MH, Korenaga M, Jen CL, Batrla-Utermann R, Lu SN, Wang LY, Mizokami M, Chen CJ, Yang HI (2017) Serum levels of M2BPGi as short-term predictors of hepatocellular carcinoma in untreated chronic hepatitis B patients. Sci Rep 7(1):14352

    Article  PubMed  PubMed Central  Google Scholar 

  19. Xu H, Kong W, Liu L, Chi X, Wang X, Wu R, Gao X, Wang H, Qu L, Qi Y, Pan Y, Niu J (2017) Accuracy of M2BPGi, compared with Fibro Scan(R), in analysis of liver fibrosis in patients with hepatitis C. BMC Gastroenterol 17(1):62

    Article  PubMed  PubMed Central  Google Scholar 

  20. Imai D, Maeda T, Wang H, Sanefuji K, Kayashima H, Yoshiya S, Takeishi K, Itoh S, Harada N, Ikegami T, Yoshizumi T, Mori M (2019) Elevation of Mac-2 binding protein glycosylation isomer after hepatectomy is associated with post-hepatectomy liver failure, total Pringle time, and renal dysfunction. Ann Gastroenterol Surg 3(5):515–522

    Article  PubMed  PubMed Central  Google Scholar 

  21. Baudi I, Inoue T, Tanaka Y (2020) Novel biomarkers of hepatitis B and hepatocellular carcinoma: clinical significance of HBcrAg and M2BPGi. Int J Mol Sci 21(3):949

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Murata A, Amano N, Sato S, Tsuzura H, Tomishima K, Sato S, Matsumoto K, Shimada Y, Iijima K, Genda T (2020) On-treatment serum Mac-2 binding protein glycosylation isomer (M2BPGi) level and risk of hepatocellular carcinoma development in patients with chronic hepatitis B during nucleot(s)ide analogue therapy. Int J Mol Sci 21(6):2051

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Takemura K, Takizawa E, Tamori A, Nakamae M, Kubota H, Uchida-Kobayashi S, Enomoto M, Kawada N, Hino M (2020) Post-treatment M2BPGi level and the rate of autotaxin reduction are predictive of hepatocellular carcinoma development after antiviral therapy in patients with chronic hepatitis C. Int J Mol Sci 21(12):4517

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Koch M, Garden OJ, Padbury R, Rahbari NN, Adam R, Capussotti L, Fan ST, Yokoyama Y, Crawford M, Makuuchi M, Christophi C, Banting S, Brooke-Smith M, Usatoff V, Nagino M, Maddern G, Hugh TJ, Vauthey JN, Greig P, Rees M, Nimura Y, Figueras J, DeMatteo RP, Büchler MW, Weitz J (2011) Bile leakage after hepatobiliary and pancreatic surgery: a definition and grading of severity by the International Study Group of Liver Surgery. Surgery 149(5):680–688

    Article  PubMed  Google Scholar 

  25. Rahbari NN, Garden OJ, Padbury R, Brooke-Smith M, Crawford M, Adam R, Koch M, Makuuchi M, Dematteo RP, Christophi C, Banting S, Usatoff V, Nagino M, Maddern G, Hugh TJ, Vauthey JN, Greig P, Rees M, Yokoyama Y, Fan ST, Nimura Y, Figueras J, Capussotti L, Büchler MW, Weitz J (2011) Posthepatectomy liver failure: a definition and grading by the International Study Group of Liver Surgery (ISGLS). Surgery 149(5):713–724

    Article  PubMed  Google Scholar 

  26. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213

    Article  PubMed  PubMed Central  Google Scholar 

  27. Takamoto T, Hashimoto T, Ogata S, Inoue K, Maruyama Y, Miyazaki A, Makuuchi M (2013) Planning of anatomical liver segmentectomy and subsegmentectomy with 3-dimensional simulation software. Am J Surg 206(4):530–538

    Article  PubMed  Google Scholar 

  28. Di Sandro S, Bagnardi V, Najjar M, Buscemi V, Lauterio A, De Carlis R, Danieli M, Pinotti E, Benuzzi L, De Carlis L (2018) Minor laparoscopic liver resection for hepatocellular carcinoma is safer than minor open resection, especially for less compensated cirrhotic patients: propensity score analysis. Surg Oncol 27(4):722–729

    Article  PubMed  Google Scholar 

  29. Worhunsky DJ, Dua MM, Tran TB, Siu B, Poultsides GA, Norton JA, Visser BC (2016) Laparoscopic hepatectomy in cirrhotics: safe if you adjust technique. Surg Endosc 30(10):4307–4314

    Article  PubMed  Google Scholar 

  30. Zhou P, Chen B, Miao XY, Zhou JJ, Xiong L, Wen Y, Zu H (2020) Comparison of FIB-4 Index and Child-Pugh Score in predicting the outcome of hepatic resection for hepatocellular carcinoma. J Gastrointest Surg 24(4):823–831

    Article  PubMed  Google Scholar 

  31. Wang YY, Zhong JH, Su ZY, Huang JF, Lu SD, Xiang BD, Ma L, Qi LN, Ou BN, Li LQ (2016) Albumin-bilirubin versus Child-Pugh score as a predictor of outcome after liver resection for hepatocellular carcinoma. Br J Surg 103(6):725–734

    Article  CAS  PubMed  Google Scholar 

  32. Zou H, Yang X, Li QL, Zhou QX, Xiong L, Wen Y (2018) A comparative study of albumin-bilirubin score with Child-Pugh Score, Model for End-Stage Liver Disease Score and indocyanine green R15 in predicting posthepatectomy liver failure for hepatocellular carcinoma patients. Dig Dis 36(3):236–243

    Article  PubMed  Google Scholar 

  33. Koths K, Taylor E, Halenbeck R, Casipit C, Wang A (1993) Cloning and characterization of a human Mac-2-binding protein, a new member of the superfamily defined by the macrophage scavenger receptor cysteine-rich domain. J Biol Chem 268(19):14245–14249

    Article  CAS  PubMed  Google Scholar 

  34. Hellstern S, Sasaki T, Fauser C, Lustig A, Timpl R, Engel J (2002) Functional studies on recombinant domains of Mac-2-binding protein. J Biol Chem 277(18):15690–15696

    Article  CAS  PubMed  Google Scholar 

  35. Tamaki N, Kurosaki M, Kuno A, Korenaga M, Togayachi A, Gotoh M, Nakakuki N, Takada H, Matsuda S, Hattori N, Yasui Y, Suzuki S, Hosokawa T, Tsuchiya K, Nakanishi H, Itakura J, Takahashi Y, Mizokami M, Narimatsu H, Izumi N (2015) Wisteria floribunda agglutinin positive human Mac-2-binding protein as a predictor of hepatocellular carcinoma development in chronic hepatitis C patients. Hepatol Res 45(10):E82–E88

    Article  CAS  PubMed  Google Scholar 

  36. Yamasaki K, Tateyama M, Abiru S, Komori A, Nagaoka S, Saeki A, Hashimoto S, Sasaki R, Bekki S, Kugiyama Y, Miyazoe Y, Kuno A, Korenaga M, Togayachi A, Ocho M, Mizokami M, Narimatsu H, Yatsuhashi H (2014) Elevated serum levels of Wisteria floribunda agglutinin-positive human Mac-2 binding protein predict the development of hepatocellular carcinoma in hepatitis C patients. Hepatology 60(5):1563–1570

    Article  CAS  PubMed  Google Scholar 

  37. Nishikawa H, Hasegawa K, Ishii A, Takata R, Enomoto H, Yoh K, Kishino K, Shimono Y, Iwata Y, Nakano C, Nishimura T, Aizawa N, Sakai Y, Ikeda N, Takashima T, Iijima H, Nishiguchi S (2016) A proposed predictive model for advanced fibrosis in patients with chronic hepatitis B and its validation. Medicine (Baltimore) 95(35):e4679

    Article  CAS  PubMed  Google Scholar 

  38. Jekarl DW, Choi H, Lee S, Kwon JH, Lee SW, Yu H, Kim M, Kim Y, Sung PS, Yoon SK (2018) Diagnosis of liver fibrosis with Wisteria floribunda agglutinin-positive Mac-2 binding protein (WFA-M2BP) among chronic hepatitis B patients. Ann Lab Med 38(4):348–354

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Tamaki N, Higuchi M, Kurosaki M, Kirino S, Osawa L, Watakabe K, Wang W, Okada M, Shimizu T, Takaura K, Takada H, Kaneko S, Yasui Y, Tsuchiya K, Nakanishi H, Itakura J, Takahashi Y, Enomoto N, Izumi N (2019) Wisteria floribunda agglutinin-positive Mac-2 binding protein as an age-independent fibrosis marker in nonalcoholic fatty liver disease. Sci Rep 9(1):10109

    Article  PubMed  PubMed Central  Google Scholar 

  40. Abe M, Miyake T, Kuno A, Imai Y, Sawai Y, Hino K, Hara Y, Hige S, Sakamoto M, Yamada G, Kage M, Korenaga M, Hiasa Y, Mizokami M, Narimatsu H (2015) Association between Wisteria floribunda agglutinin-positive Mac-2 binding protein and the fibrosis stage of non-alcoholic fatty liver disease. J Gastroenterol 50(7):776–784

    Article  CAS  PubMed  Google Scholar 

  41. Uchida H, Iwashita Y, Tada K, Saga K, Takayama H, Hirashita T, Endo Y, Ohta M, Inomata M (2018) Laparoscopic liver resection in cirrhotic patients with specific reference to a difficulty scoring system. Langenbecks Arch Surg 403(3):371–377

    Article  PubMed  Google Scholar 

  42. Haber PK, Wabitsch S, Krenzien F, Benzing C, Andreou A, Schöning W, Öllinger R, Pratschke J, Schmelzle M (2019) Laparoscopic liver surgery in cirrhosis—addressing lesions in posterosuperior segments. Surg Oncol 28:140–144

    Article  PubMed  Google Scholar 

  43. Cipriani F, Fantini C, Ratti F, Lauro R, Tranchart H, Halls M, Scuderi V, Barkhatov L, Edwin B, Troisi RI, Dagher I, Reggiani P, Belli G, Aldrighetti L, Abu Hilal M (2018) Laparoscopic liver resections for hepatocellular carcinoma. Can we extend the surgical indication in cirrhotic patients? Surg Endosc 32(2):617–626

    Article  PubMed  Google Scholar 

  44. Ichida A, Hasegawa K, Takayama T, Kudo H, Sakamoto Y, Yamazaki S, Midorikawa Y, Higaki T, Matsuyama Y, Kokudo N (2016) Randomized clinical trial comparing two vessel-sealing devices with crush clamping during liver transection. Br J Surg 103(13):1795–1803

    Article  CAS  PubMed  Google Scholar 

  45. Takayama T, Makuuchi M, Kubota K, Harihara Y, Hui AM, Sano K, Ijichi M, Hasegawa K (2001) Randomized comparison of ultrasonic vs clamp transection of the liver. Arch Surg 136(8):922–928

    Article  CAS  PubMed  Google Scholar 

  46. Ikeda M, Hasegawa K, Sano K, Imamura H, Beck Y, Sugawara Y, Kokudo N, Makuuchi M (2009) The vessel sealing system (LigaSure) in hepatic resection: a randomized controlled trial. Ann Surg 250(2):199–203

    Article  PubMed  Google Scholar 

  47. Ohshima S (2014) Volume analyzer SYNAPSE VINCENT for liver analysis. J Hepatobiliary Pancreat Sci 21(4):235–238

    Article  PubMed  Google Scholar 

  48. Eiriksson K, Fors D, Rubertsson S, Arvidsson D (2011) High intra-abdominal pressure during experimental laparoscopic liver resection reduces bleeding but increases the risk of gas embolism. Br J Surg 98:845–852

    Article  CAS  PubMed  Google Scholar 

  49. Kobayashi S, Honda G, Kurata M, Tadano S, Sakamoto K, Okuda Y, Abe K (2016) An experimental study on the relationship among airway pressure, pneumoperitoneum pressure, and central venous pressure in pure laparoscopic hepatectomy. Ann Surg 263(6):1159–1163

    Article  PubMed  Google Scholar 

  50. Halls MC, Alseidi A, Berardi G, Cipriani F, Van der Poel M, Davila D, Ciria R, Besselink M, D’Hondt M, Dagher I, Alrdrighetti L, Troisi RI, Abu Hilal M (2019) A comparison of the learning curves of laparoscopic liver surgeons in differing stages of the IDEAL paradigm of surgical innovation: standing on the shoulders of pioneers. Ann Surg 269(2):221–228

    Article  PubMed  Google Scholar 

  51. Gumbs AA, Hilal MA, Croner R, Gayet B, Chouillard E, Gagner M (2021) The initiation, standardization and proficiency (ISP) phases of the learning curve for minimally invasive liver resection: comparison of a fellowship-trained surgeon with the pioneers and early adopters. Surg Endosc 35(9):5268–5278

    Article  PubMed  Google Scholar 

  52. Gumbs AA, Lorenz E, Tsai TJ, Starker L, Flanagan J, Benedetti Cacciaguerra A, Yu NJ, Bajul M, Chouillard E, Croner R, Abu Hilal M (2022) Study: international multicentric minimally invasive liver resection for colorectal liver metastases (SIMMILR-CRLM). Cancers (Basel) 14(6):1379

    Article  PubMed  Google Scholar 

  53. Perrakis A, Rahimli M, Gumbs AA, Negrini V, Andric M, Stockheim J, Wex C, Lorenz E, Arend J, Franz M, Croner RS (2021) Three-device (3D) technique for liver parenchyma dissection in robotic liver surgery. J Clin Med 10(22):5265

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Author notes

  1. Tomokazu Fuji and Toru Kojima have contributed equally to this work.

Authors and Affiliations

  1. Department of Surgery, Okayama Saiseikai General Hospital, 2-25 Kokutaicho, Kita-ku, Okayama, 700-8511, Japan

    Tomokazu Fuji, Toru Kojima, Hiroki Kajioka, Misaki Sakamoto, Ryoya Oka, Tetsuya Katayama, Yuki Narahara & Takefumi Niguma

Authors
  1. Tomokazu Fuji
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Toru Kojima
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hiroki Kajioka
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Misaki Sakamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ryoya Oka
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Tetsuya Katayama
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yuki Narahara
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Takefumi Niguma
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Toru Kojima.

Ethics declarations

Disclosures

Tomokazu Fuji, Toru Kojima, Hiroki Kajioka, Misaki Sakamoto, Ryoya Oka, Tetsuya Katayama, Yuki Narahara, and Takefumi Niguma have no conflicts of interest or financial ties to disclose.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (TIF 117 KB)

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fuji, T., Kojima, T., Kajioka, H. et al. The preoperative M2BPGi score predicts operative difficulty and the incidence of postoperative complications in laparoscopic liver resection. Surg Endosc 37, 1262–1273 (2023). https://doi.org/10.1007/s00464-022-09664-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-022-09664-2

Keywords

Search

Navigation