Application of a novel surgical difficulty grading system during laparoscopic cholecystectomy

Koji Asai, Yukio Iwashita, Tetsuji Ohyama, Itaru Endo, Taizo Hibi, Akiko Umezawa, Kenji Suzuki, Manabu Watanabe, Masanao Kurata, Yasuhisa Mori, Masaharu Higashida, Yusuke Kumamoto, Junichi Shindoh, Masahiro Yoshida, Goro Honda, Takeyuki Misawa, Yuta Abe, Yuichi Nagakawa, Naoyuki Toyota, Shigetoshi YamadaShinji Norimizu, Naoki Matsumura, Naohiro Sata, Hiroki Sunagawa, Masahiro Ito, Yutaka Takeda, Yoshiharu Nakamura, Toshiki Rikiyama, Ryota Higuchi, Takeshi Gocho, Yuki Homma, Teijiro Hirashita, Hideyuki Kanemoto, Masashi Nozawa, Yusuke Watanabe, Atsushi Kohga, Takehisa Yazawa, Hiroshi Tajima, Shin Nakahira, Tadafumi Asaoka, Ryuji Yoshioka, Junya Fukuzawa, Shuichi Fujioka, Taigo Hata, Hidenori Haruta, Yukio Asano, Ryohei Nomura, Joe Matsumoto, Noriaki Kameyama, Atsushi Miyoshi, Hidejiro Urakami, Yasuji Seyama, Takanori Morikawa, Yoichi Kawano, Hisashi Ikoma, Dal Ho Kim Kin, Tadahiro Takada, Masakazu Yamamoto

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Prevention of bile duct injury and vasculo-biliary injury while performing laparoscopic cholecystectomy (LC) is an unsolved problem. Clarifying the surgical difficulty using intraoperative findings can greatly contribute to the pursuit of best practices for acute cholecystitis. In this study, multiple evaluators assessed surgical difficulty items in unedited videos and then constructed a proposed surgical difficulty grading. Methods: We previously assembled a library of typical video clips of the intraoperative findings for all LC surgical difficulty items in acute cholecystitis. Fifty-one experts on LC assessed unedited surgical videos. Inter-rater agreement was assessed by Fleiss's κ and Gwet's agreement coefficient (AC). Results: Except for one item (“edematous change”), κ or AC exceeded 0.5, so the typical videos were judged to be applicable. The conceivable surgical difficulty gradings were analyzed. According to the assessment of difficulty factors, we created a surgical difficulty grading system (agreement probability = 0.923, κ = 0.712, 90% CI: 0.587-0.837; AC2 = 0.870, 90% CI: 0.768-0.972). Conclusion: The previously published video clip library and our novel surgical difficulty grading system should serve as a universal objective tool to assess surgical difficulty in LC.

Original languageEnglish
Pages (from-to)758-767
Number of pages10
JournalJournal of Hepato-Biliary-Pancreatic Sciences
Volume29
Issue number7
DOIs
Publication statusPublished - 07-2022
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Hepatology

Fingerprint

Dive into the research topics of 'Application of a novel surgical difficulty grading system during laparoscopic cholecystectomy'. Together they form a unique fingerprint.

Cite this