腹腔鏡下肝切除術difficulty scoring systemの検証

Validation of difficulty scoring system for laparoscopic liver resection by short-term outcome

◆要旨：［目的］手術難度の客観的な評価は腹腔鏡下肝切除術の安全な導入，展開に必要である．当科の腹腔鏡下肝切除術（HALS, Hybridを除く）の短期手術成績を用いてdifficulty scoring system（Banら．JHBPS, 2014）の妥当性を検証した．［方法］2004年12月〜2014年12月の腹腔鏡下肝切除術74例を対象とし，後ろ向きに検討した．［結果］総合点を3点以下と4点以上の2群に分けて検討すると，手術時間と開腹移行比率，術後合併症頻度に有意差を認めた．［結論］当科の症例においてもdifficulty scoring systemは手術難度を示す有効な指標と考えられた．

［Objective］ The objective estimate system for degree of difficulty of pure laparoscopic liver resection is important to introduce it safely.The purpose of this study is to validate the significance of difficulty scoring system for laparoscopic liver resection（Ban et al. JHBPS,2014） by short-term outcome. ［Method］ We retrospectively assesed the score and short-term outcome in 74 patients who underwent pure laparoscopic liver resection from 2004 to 2014. ［Result］ We devided the patients into two groups, low（1-3points） group and high（4-6points） group.Operative time was prolonged, and conversion and morbidity rates were significantly increased in the high group. ［Conclusion］ Difficulty scoring system was useful to predict difficulty of laparoscopic liver resection.