Association between surgical difficulty and tumor location based on subsegments of the Glisson branches in laparoscopic liver resection.

• Tác giả: Tomohiro Arita, Hitoshi Fujiwara, Hisashi Ikoma, Taisuke Imamura, Hirotaka Konishi, Takeshi Kubota, Ryo Morimura, Eigo Otsuji, Atsushi Shiozaki, Yusuke Yamamoto
• Ngôn ngữ: eng
• Thông tin xuất bản: Japan : Annals of gastroenterological surgery , 2025
• Bộ sưu tập: NCBI
• ID: 747268

Tóm tắt

 BACKGROUND: Laparoscopic liver resection has a steep learning curve, and multiple difficulty-scoring systems have been proposed to support safe implementation. Though the IWATE scoring system is widely used, the rationale for its tumor location score is unclear. The objective of our study was to establish a more accurate definition of tumor location based on subsegments of the Glisson branches. METHODS: We included 176 patients who underwent laparoscopic liver resection between January 2017 and February 2024, excluding those who underwent multiple or concomitant resections of other organs. Tumor location was defined by the most proximal subsegment of the Glisson branches (1sp, Spiegel
  1pc, para-caval
  1cp, caudate process
  3a, apical
  3b, basal
  4a
  4b
  5v, ventral
  5d, dorsal
  6v
  6d
  6 L, lateral
  7v
  7d
  8v
  8d). RESULTS: Within each segment, comparing operative time between subsegments showed significant differences, except for S1 (3a vs. 3b, CONCLUSIONS: There are significant differences in the difficulty of laparoscopic liver resection among subsegments. More detailed scoring based on subsegments may improve accuracy, and we propose a new scoring system.