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What are the appropriate indicators of surgical difficulty during laparoscopic cholecystectomy? Results from a Japan-Korea-Taiwan multinational survey

Authors :
Yukio, Iwashita
Tetsuji, Ohyama
Goro, Honda
Taizo, Hibi
Masahiro, Yoshida
Fumihiko, Miura
Tadahiro, Takada
Ho-Seong, Han
Tsann-Long, Hwang
Satoshi, Shinya
Kenji, Suzuki
Akiko, Umezawa
Yoo-Seok, Yoon
In-Seok, Choi
Wayne Shih-Wei, Huang
Kuo-Hsin, Chen
Manabu, Watanabe
Yuta, Abe
Takeyuki, Misawa
Yuichi, Nagakawa
Dong-Sup, Yoon
Jin-Young, Jang
Hee Chul, Yu
Keun Soo, Ahn
Song Cheol, Kim
In Sang, Song
Ji Hoon, Kim
Sung Su, Yun
Seong Ho, Choi
Yi-Yin, Jan
Shyr-Ming, Sheen-Chen
Yan-Shen, Shan
Chen-Guo, Ker
De-Chuan, Chan
King-Teh, Lee
Naoyuki, Toyota
Ryota, Higuchi
Yoshiharu, Nakamura
Yoshiaki, Mizuguchi
Yutaka, Takeda
Masahiro, Ito
Shinji, Norimizu
Shigetoshi, Yamada
Naoki, Matsumura
Junichi, Shindoh
Hiroki, Sunagawa
Hiroshi, Hasegawa
Toshiki, Rikiyama
Naohiro, Sata
Nobuyasu, Kano
Seigo, Kitano
Hiromi, Tokumura
Yuichi, Yamashita
Goro, Watanabe
Kunitoshi, Nakagawa
Taizo, Kimura
Tatsuo, Yamakawa
Go, Wakabayashi
Itaru, Endo
Masaru, Miyazaki
Masakazu, Yamamoto
Source :
Journal of hepato-biliary-pancreatic sciences. 23(9)
Publication Year :
2016

Abstract

Serious complications continue to occur in laparoscopic cholecystectomy (LC). The commonly used indicators of surgical difficulty such as the duration of surgery are insufficient because they are surgeon and institution dependent. We aimed to identify appropriate indicators of surgical difficulty during LC.A total of 26 Japanese expert LC surgeons discussed using the nominal group technique (NGT) to generate a list of intraoperative findings that contribute to surgical difficulty. Thereafter, a survey was circulated to 61 experts in Japan, Korea, and Taiwan. The questionnaire addressed LC experience, surgical strategy, and perceptions of 30 intraoperative findings listed by the NGT.The response rate of the survey was 100%. There was a statistically significant difference among nations regarding the duration of surgery and adoption rate of safety measures and recognition of landmarks. The criteria for conversion to an open or subtotal cholecystectomy were at the discretion of each surgeon. In contrast, perceptions of the impact of 30 intraoperative findings on surgical difficulty (categorized by factors related to inflammation and additional findings of the gallbladder and other intra-abdominal factors) were consistent among surgeons.Intraoperative findings are objective and considered to be appropriate indicators of surgical difficulty during LC.

Details

ISSN :
18686982
Volume :
23
Issue :
9
Database :
OpenAIRE
Journal :
Journal of hepato-biliary-pancreatic sciences
Accession number :
edsair.pmid..........90a29049402794e02c848e0f3b8909d6