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The “right” way is not always popular: comparison of surgeons’ perceptions during laparoscopic cholecystectomy for acute cholecystitis among experts from Japan, Korea and Taiwan
Author(s) -
Hibi Taizo,
Iwashita Yukio,
Ohyama Tetsuji,
Honda Goro,
Yoshida Masahiro,
Takada Tadahiro,
Han HoSeong,
Hwang TsannLong,
Shinya Satoshi,
Suzuki Kenji,
Umezawa Akiko,
Yoon YooSeok,
Choi InSeok,
Huang Wayne ShihWei,
Chen KuoHsin,
Miura Fumihiko,
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,
Wu ChengChung,
Toyota Naoyuki,
Higuchi Ryota,
Nakamura Yoshiharu,
Mizuguchi Yoshiaki,
Takeda Yutaka,
Ito Masahiro,
Norimizu Shinji,
Yamada Shigetoshi,
Matsumura Naoki,
Shindoh Junichi,
Sunagawa Hiroki,
Gocho Takeshi,
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 - 2017
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.417
Subject(s) - medicine , laparoscopic cholecystectomy , grading (engineering) , open cholecystectomy , acute cholecystitis , perception , cholecystectomy , general surgery , surgery , psychology , civil engineering , neuroscience , engineering
Background Generally, surgeons’ perceptions of surgical safety are based on experience and institutional policy. Our recent pilot survey demonstrated that the acceptable duration of surgery and criteria for open conversion during laparoscopic cholecystectomy ( LC ) vary among workplaces. Methods A web‐based survey was distributed to 554 expert LC surgeons in Japan, Korea, and Taiwan. The questionnaire covered LC experience, safety measures and recognition of landmarks, decision‐making regarding conversion to open/partial cholecystectomy and the implications of this decision. Overall responses were compared among nations, and then stratified by LC experience level (lifetime cases 200–499, 500–999, and ≥1,000). Results The response rate was 92.6% (513/554); 67 surgeons with ≤199 LC s were excluded, and responses from 446 surgeons were analyzed. We observed significant differences among nations on almost all questions. Differences that remained after stratification by LC experience were on questions related to acceptable duration of surgery, adoption rates of intraoperative cholangiography, the “critical view of safety” technique, identification of Rouvière's sulcus, recognition of the SS ‐Inner layer theory, and intraoperative judgment to abandon conventional LC . Conclusions Even among experts, surgeons’ perceptions during LC are workplace‐dependent. A novel grading system of surgical difficulty and standardized LC procedures are paramount to generate high‐level evidence.