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

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 NagakawaDong 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

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)533-547
Number of pages15
JournalJournal of Hepato-Biliary-Pancreatic Sciences
Volume23
Issue number9
DOIs
Publication statusPublished - 01-09-2016

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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    Iwashita, Y., Ohyama, T., Honda, G., Hibi, T., Yoshida, M., Miura, F., Takada, T., Han, H. S., Hwang, T. L., Shinya, S., Suzuki, K., Umezawa, A., Yoon, Y. S., Choi, I. S., Huang, W. S. W., Chen, K. H., Watanabe, M., Abe, Y., Misawa, T., ... Yamamoto, M. (2016). What are the appropriate indicators of surgical difficulty during laparoscopic cholecystectomy? Results from a Japan-Korea-Taiwan multinational survey. Journal of Hepato-Biliary-Pancreatic Sciences, 23(9), 533-547. https://doi.org/10.1002/jhbp.375