ASO Author Reflections: Cirrhosis and Severity of Cirrhosis Negatively Affects the Outcomes of Laparoscopic and Robotic Major Liver Resections for Primary Liver Malignancies

Excerpt

Minimally invasive liver resection (MILR) has been widely adopted worldwide due to its multitude of benefits, such as reduced blood loss and lower morbidity rates, with comparable oncologic outcomes to the traditional open approach.¹ Difficulty scoring systems (DSS) have been developed to predict the complexity level of MILR procedures preoperatively, so as to facilitate appropriate case selection according to the expertise level of individual surgeons and to enable more accurate benchmarking.² Liver cirrhosis (LC) is often present in patients with primary hepatic malignancies, and this compounds the difficulty of liver resection by increasing the risk of bleeding, post-hepatectomy liver failure, and other perioperative complications.³ At present, only the Iwate score accords difficulty points for Child–Pugh B (CP-B) cirrhosis, but does not distinguish between patients with Child–Pugh A (CP-A) cirrhotic and non-cirrhotic patients.⁴ We therefore performed this study in order to investigate the impact of the degree of cirrhosis on outcomes following minimally invasive major hepatectomy (MIMH). …