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Validation and comparison of the Iwate, IMM, Southampton and Hasegawa difficulty scoring systems for primary laparoscopic hepatectomies
- Source :
- HPB. 23:770-776
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Background Various difficulty scoring systems (DSS) have been formulated to grade the complexity of laparoscopic hepatectomies (LH). This study aims to externally validate and compare 4 contemporary DSS including the Iwate, Institut Mutualiste Montsouris (IMM), Southampton and Hasegawa DSS in predicting the intraoperative technical difficulty and postoperative outcomes after LH. Methods Retrospective review of 548 consecutive patients who underwent LH of which 455 met the study inclusion criteria. Outcomes measures of technical difficulty included operation time, Pringles maneuver, blood loss and blood transfusion rate. Postoperative outcomes measured included morbidity, major morbidity and postoperative hospital stay. Results There was a statistically significant progressive increase in blood loss, blood transfusion rate, operation time and postoperative stay associated with all 4 DSS. There was also good calibration with respect to blood loss, operation time, Pringles maneuver, open conversion rate, postoperative morbidity, postoperative major morbidity and postoperative stay for all 4 DSS. The Southampton score demonstrated the poorest calibration in terms of operation time and discrimination in terms of application of Pringles maneuver and major morbidity amongst all 4 systems. Conclusion All 4 DSS significantly correlated with outcome measures associated with intraoperative technical difficulty and postoperative outcomes. The Southampton DSS was the poorest system in our cohort of patients.
- Subjects :
- medicine.medical_specialty
Blood transfusion
medicine.medical_treatment
Operative Time
030230 surgery
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Blood loss
medicine
Hepatectomy
Humans
Operation time
Retrospective Studies
Retrospective review
Hepatology
business.industry
General surgery
Liver Neoplasms
Gastroenterology
Outcome measures
Length of Stay
030220 oncology & carcinogenesis
Cohort
Laparoscopy
business
Hospital stay
Subjects
Details
- ISSN :
- 1365182X
- Volume :
- 23
- Database :
- OpenAIRE
- Journal :
- HPB
- Accession number :
- edsair.doi.dedup.....77db35ed142c7c3265b6729c86bf2c5d