Detailed Abstract
[E-poster - Stone Diseases]
[EP-011] Validation Of Difficulty Scoring System Of Laparoscopic Liver Resection For Hepatolithiasis
Jinju KIM1 , Jai Young CHO*1 , Ho-Seong HAN1 , Yoo-Seok YOON1 , Hae Won LEE1 , Boram LEE1 , MeeYoung KANG1 , Yeshong PARK1
1 General Surgery, 분당서울대학교병원, REPUBLIC OF KOREA
Background : We previously developed a modified difficulty scoring system (DSS-IHD) of laparoscopic liver resection (LLR) for patients with intrahepatic duct (IHD) stone. We validated DSS-IHD in patients who underwent LLR for hepatolithiasis.
Methods : DSS-IHD was based on the extent of liver resection (2 ~ 4), stone location (1 ~ 5), atrophy of liver parenchyma (0 ~ 1), ductal stricture < 1 cm from the bifurcation (0 ~ 1), and combined choledochoscopic examination for remnant IHD (0 ~ 1).
Results : The DSS-IHD ranged from 3 to 12 and divided to 3-level groups of low group (score 3 ~5; n = 26), intermediate group (6 ~ 8; n = 72), and high group (9 ~ 12; n = 23). The mean operation time (187.4 80.2 vs. 348.8 147.6 vs. 367.8 141.1; P < 0.001) and the mean blood loss (354.2 301.3 vs. 849.4 968.4 vs. 1083.0 955.2; P = 0.004) were significantly different among groups. The mean hospital stay was also marginally different among groups (7.6 3.5 vs. 13.4 11.6 vs. 13.2 11.2; P = 0.054). When we simply divided patients by right and left LLR, there were significant differences in DSS-IHD (8.9 2.0 vs. 6.5 1.6; P < 0.001), operation time (472.4 185.3 vs. 289.7 124.5; P <0.001) and blood loss (1810.5 1269.7 vs. 596.8 656.1; P = 0.001) between right and left LLR group.
Conclusions : The surgical difficulty varies among patients undergoing LLR for IHD stones. The DSS-IHD predicts well the surgical difficulties of LLR for patients with IHD stones.
Methods : DSS-IHD was based on the extent of liver resection (2 ~ 4), stone location (1 ~ 5), atrophy of liver parenchyma (0 ~ 1), ductal stricture < 1 cm from the bifurcation (0 ~ 1), and combined choledochoscopic examination for remnant IHD (0 ~ 1).
Results : The DSS-IHD ranged from 3 to 12 and divided to 3-level groups of low group (score 3 ~5; n = 26), intermediate group (6 ~ 8; n = 72), and high group (9 ~ 12; n = 23). The mean operation time (187.4 80.2 vs. 348.8 147.6 vs. 367.8 141.1; P < 0.001) and the mean blood loss (354.2 301.3 vs. 849.4 968.4 vs. 1083.0 955.2; P = 0.004) were significantly different among groups. The mean hospital stay was also marginally different among groups (7.6 3.5 vs. 13.4 11.6 vs. 13.2 11.2; P = 0.054). When we simply divided patients by right and left LLR, there were significant differences in DSS-IHD (8.9 2.0 vs. 6.5 1.6; P < 0.001), operation time (472.4 185.3 vs. 289.7 124.5; P <0.001) and blood loss (1810.5 1269.7 vs. 596.8 656.1; P = 0.001) between right and left LLR group.
Conclusions : The surgical difficulty varies among patients undergoing LLR for IHD stones. The DSS-IHD predicts well the surgical difficulties of LLR for patients with IHD stones.
SESSION
E-poster
E-Session 09/08 ALL DAY