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Difficulty scoring system in laparoscopic distal pancreatectomy
Author(s) -
Ohtsuka Takao,
Ban Daisuke,
Nakamura Yoshiharu,
Nagakawa Yuichi,
Tanabe Minoru,
Gotoh Yoshitaka,
Velasquez Vittoria Vanessa D. M.,
Nakata Kohei,
Sahara Yatsuka,
Takaori Kyoichi,
Honda Goro,
Misawa Takeyuki,
Kawai Manabu,
Yamaue Hiroki,
Morikawa Takanori,
Kuroki Tamotsu,
Mou Yiping,
Lee WooJung,
Shrikhande Shailesh V.,
Tang Chung Ngai,
Conrad Claudius,
Han HoSeong,
Palanivelu Chinnusamy,
Asbun Horacio J.,
Kooby David A.,
Wakabayashi Go,
Takada Tadahiro,
Yamamoto Masakazu,
Nakamura Masafumi
Publication year - 2018
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.578
Subject(s) - distal pancreatectomy , concordance , medicine , statistic , index (typography) , kappa , scoring system , cohen's kappa , splenectomy , surgery , resection , statistics , computer science , mathematics , geometry , spleen , world wide web
Background Several factors affect the level of difficulty of laparoscopic distal pancreatectomy ( LDP ). The purpose of this study was to develop a difficulty scoring ( DS ) system to quantify the degree of difficulty in LDP . Methods We collected clinical data for 80 patients who underwent LDP. A 10‐level difficulty index was developed and subcategorized into a three‐level difficulty index; 1–3 as low, 4–6 as intermediate, and 7–10 as high index. The automatic linear modeling (LINEAR) statistical tool was used to identify factors that significantly increase level of difficulty in LDP. Results The operator's 10‐level DS concordance between the 10‐level DS by the reviewers, LINEAR index DS , and clinical index DS systems were analyzed, and the weighted Cohen's kappa statistic were at 0.869, 0.729, and 0.648, respectively, showing good to excellent inter‐rater agreement. We identified five factors significantly affecting level of difficulty in LDP; type of operation, resection line, proximity of tumor to major vessel, tumor extension to peripancreatic tissue, and left‐sided portal hypertension/splenomegaly. Conclusions This novel DS for LDP adequately quantified the degree of difficulty, and can be useful for selecting patients for LDP, in conjunction with fitness for surgery and prognosis.