Journal of the American College of Surgeons
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Multicenter Study
Validation of a Difficulty Scoring System for Laparoscopic Liver Resection: A Multicenter Analysis by the Endoscopic Liver Surgery Study Group in Japan.
Laparoscopic liver resection (LLR) is widely used for hepatic disease treatment. Preoperative prediction of operative difficulty can be beneficial as a roadmap for surgeons advancing from simple to highly technical LLR. We performed a multicenter analysis to investigate a "difficulty scoring system" for predicting the difficulty of LLR. ⋯ Preoperative evaluation with the "difficulty scoring system" predicted the difficulty of the operation and the postoperative outcomes of LLR. In the beginning of LLR training, surgeons should start with low difficulty-level operations.
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Although laparoscopic pancreatic resection (LPR) has become routine, large single-center series are still lacking. Our aim was to analyze the results of a large European single-center series of LPR. ⋯ Laparoscopic pancreatic resection without a reconstruction phase has excellent outcomes; LPR with a reconstruction phase, especially PD, has less favorable outcomes, and further randomized studies are required to draw conclusions on the safety and benefits of this approach.