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An opportunity in difficulty: Japan–Korea–Taiwan expert Delphi consensus on surgical difficulty during laparoscopic cholecystectomy
Author(s) -
Iwashita Yukio,
Hibi Taizo,
Ohyama Tetsuji,
Honda Goro,
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,
Shan YanShen,
Ker ChenGuo,
Chan DeChuan,
Wu ChengChung,
Lee KingTeh,
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,
Mori Rintaro,
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.440
Subject(s) - medicine , interquartile range , delphi method , delphi , laparoscopic cholecystectomy , general surgery , cholecystectomy , expert opinion , surgery , intensive care medicine , statistics , mathematics , computer science , operating system
Background We previously identified 25 intraoperative findings during laparoscopic cholecystectomy ( LC ) as potential indicators of surgical difficulty per nominal group technique. This study aimed to build a consensus among expert LC surgeons on the impact of each item on surgical difficulty. Methods Surgeons from Japan, Korea, and Taiwan ( n = 554) participated in a Delphi process and graded the 25 items on a seven‐stage scale (range, 0–6). Consensus was defined as (1) the interquartile range ( IQR ) of overall responses ≤2 and (2) ≥66% of the responses concentrated within a median ± 1 after stratification by workplace and LC experience level. Results Response rates for the first and the second‐round Delphi were 92.6% and 90.3%, respectively. Final consensus was reached for all the 25 items. ‘Diffuse scarring in the Calot's triangle area’ in the ‘Factors related to inflammation of the gallbladder’ category had the strongest impact on surgical difficulty (median, 5; IQR , 1). Surgeons agreed that the surgical difficulty increases as more fibrotic change and scarring develop. The median point for each item was set as the difficulty score. Conclusions A Delphi consensus was reached among expert LC surgeons on the impact of intraoperative findings on surgical difficulty.