Iwate scoring system effectively stratifies laparoscopic liver resections

An international multicenter study validated the Iwate difficulty scoring system (DSS) for laparoscopic liver resections (LLR) across both its four difficulty levels and 12-point difficulty index. Analyzing 14,759 patients, researchers found that intraoperative and postoperative outcomes—such as operation time, blood loss, and complications—worsened significantly with higher difficulty levels (p < 0.001). These findings, derived from various perioperative measures, confirm the correlations between the Iwate DSS and LLR difficulty.