• Hiroki Uchida, Yukio Iwashita, Kunihiro Saga, Hiroomi Takayama, Kiminori Watanabe, Yuichi Endo, Kazuhiro Yada, Masayuki Ohta, and Masafumi Inomata.
• Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine , Oita, Japan .
• J Laparoendosc Adv Surg Tech A. 2016 Sep 1; 26 (9): 702-6.

IntroductionLaparoscopic liver resection (LLR) has several problems, such as technical complexity and patient and tumor factors. A difficulty scoring system to preoperatively evaluate the difficulty of LLR was established at the second International Consensus Conference on Laparoscopic Liver Resection. The aim of this study was to explore the clinical usefulness of the difficulty scoring system for LLR.Patients And MethodsFrom January 2010 to June 2015, the records of 78 patients who had undergone LLR were retrospectively reviewed. The patients' data were used to assign a difficulty score, and the correlations between scores and surgical outcomes were investigated.ResultsThe mean surgical time was 256 minutes, and the mean blood loss was 168 mL. The difficulty score significantly correlated with surgical time and blood loss, but not with morbidity and postoperative hospital stay. Multivariate analysis showed that the difficulty score was an independent predictor of prolonged surgical time.ConclusionsThe difficulty score was found to be an effective predictor of surgical time for LLR.

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