ホンダ　ゴロウ   HONDA Gorou   本田　五郎    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	Application of a novel surgical difficulty grading system during laparoscopic cholecystectomy.
掲載誌名	正式名：Journal of hepato-biliary-pancreatic sciences 略　 称：J Hepatobiliary Pancreat Sci ISSNコード：18686982/18686974
掲載区分	国内
巻・号・頁	29(7),pp.758-767
著者・共著者	ASAI Koji, IWASHITA Yukio, OHYAMA Tetsuji, ENDO Itaru, HIBI Taizo, UMEZAWA Akiko, SUZUKI Kenji, WATANABE Manabu, KURATA Masanao, MORI Yasuhisa, HIGASHIDA Masaharu, KUMAMOTO Yusuke, SHINDOH Junichi, YOSHIDA Masahiro, HODAN Goro, MISAWA Takeyuki, ABE Yuta, NAGAKAWA Yuichi, TIYAMA Naoyuki, YAMADA Shigetoshi, NORIMIZU Shinji, MATSUMURA Naoki, SATA Naohiro, SUNAGAWA Hiroki, ITO Masahiro, TAKADA Yutaka, NAKAMURA Yoshiharu, RIKIYAMA Toshiki, HIGUCHI Ryota, GOCHO Takeshi, HOMMA Yuki, HIRASHITA Teijiro, KANEKOTO Hideyuki, NOZAWA Masashi, WATANABE Yusuke, KOHGA Atsushi, YAZAWA Takehisa, TAJIMA Hiroshi, NAKAHIRA Shin, ASAOKA Tadafumi, YOSHIOKA Ryuji, FUKUZAWA Junya, FUJIOKA Shuichi, HATA Taigo, HARUTA Hidenori, ASANO Yukio, NOMURA Ryohei, MATSUMOTO Joe, KAMEYAMA Noriaki, MIYOSHI Atsushi, URAKAMI Hidejiro, SEYAMA Yasuji, MORIKAWA Takanori, KAWAMO Yoichi, IKOMA Hisashi, Kin Dal Ho Kim, TAKADA Tadahiro, YAMAMOTO Masakazu
発行年月	2022/07
概要	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.
DOI	10.1002/jhbp.1068
PMID	34748289