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What are the appropriate indicators of surgical difficulty during laparoscopic cholecystectomy? Results from a Japan‐Korea‐Taiwan multinational survey
Author(s) -
Iwashita Yukio,
Ohyama Tetsuji,
Honda Goro,
Hibi Taizo,
Yoshida Masahiro,
Miura Fumihiko,
Takada Tadahiro,
Han HoSeong,
Hwang TsannLong,
Shinya Satoshi,
Suzuki Kenji,
Umezawa Akiko,
Yoon YooSeok,
Choi InSeok,
Huang Wayne ShihWei,
Chen KuoHsin,
Watanabe Manabu,
Abe Yuta,
Misawa Takeyuki,
Nagakawa Yuichi,
Yoon DongSup,
Jang JinYoung,
Yu Hee Chul,
Ahn Keun Soo,
Kim Song Cheol,
Song In Sang,
Kim Ji Hoon,
Yun Sung Su,
Choi Seong Ho,
Jan YiYin,
SheenChen ShyrMing,
Shan YanShen,
Ker ChenGuo,
Chan DeChuan,
Lee KingTeh,
Toyota Naoyuki,
Higuchi Ryota,
Nakamura Yoshiharu,
Mizuguchi Yoshiaki,
Takeda Yutaka,
Ito Masahiro,
Norimizu Shinji,
Yamada Shigetoshi,
Matsumura Naoki,
Shindoh Junichi,
Sunagawa Hiroki,
Hasegawa Hiroshi,
Rikiyama Toshiki,
Sata Naohiro,
Kano Nobuyasu,
Kitano Seigo,
Tokumura Hiromi,
Yamashita Yuichi,
Watanabe Goro,
Nakagawa Kunitoshi,
Kimura Taizo,
Yamakawa Tatsuo,
Wakabayashi Go,
Endo Itaru,
Miyazaki Masaru,
Yamamoto Masakazu
Publication year - 2016
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.375
Subject(s) - medicine , laparoscopic cholecystectomy , general surgery , surgery , multinational corporation , political science , law
Background 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. Methods 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. Results 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. Conclusions Intraoperative findings are objective and considered to be appropriate indicators of surgical difficulty during LC.