Ban et al reported scores for predicting the difficulty of a laparoscopic liver resection. The authors are from Tokyo Medical and Dental University, Toho University, Iwate Medical University and Keio University.
Patient selection: candidate for laparoscopic resection of a tumor mass, Child-Pugh grade A or B
Parameters:
(1) extent of liver resection
(2) tumor location by hepatic segment (from 2 to 8)
(3) tumor size in cm
(4) proximity to the main or secondary branches of Glisson's tree to the major hepatic vein or inferior vena cava
(5) Child-Pugh score (as a measure of liver function)
Liver Resection
Procedure
Hr0
partial
HrS
segmentectomy
Hr-LLS
left lateral sectionectomy
Hr1
sectionectomy except for left lateral
Hr2
bisectionectomy
Hr3
trisectionectomy
Parameter
Finding
Points for Difficulty Index
Points for Score
extent of liver resection
Hr0
-3.687
0
Hr-LLS
-2.228
2
Hr-S
-0.633
3
Hr-1,2,3
0
4
tumor location
segment S2
0
2
S3
0
1
S4
0.575
3
S5
0.575
3
S6
0
2
S7
2.145
5
S8
2.145
5
tumor size
< 3 cm
0.148 * (size)
0
>= 3 cm
0.148 * (size)
1
proximity to major vessel
no
0
0
yes
0.594
1
Child Pugh
Child-Pugh A
0
0
Child Pugh B
1.223
1
difficulty index =
= 6.123 + SUM(difficulty index points)
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 1
• maximum score: 12
• The higher the results the greater the difficulty of the procedure.
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