HIGUCHI Ryota
   Department   School of Medicine(Yachiyo Medical Center), School of Medicine
   Position   Assistant Professor
Article types Original article
Language English
Peer review Non peer reviewed
Title Application of a novel surgical difficulty grading system during laparoscopic cholecystectomy.
Journal Formal name:Journal of hepato-biliary-pancreatic sciences
Abbreviation:J Hepatobiliary Pancreat Sci
ISSN code:18686982/18686974
Domestic / ForeginDomestic
Volume, Issue, Page 29(7),pp.758-767
Author and coauthor 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
Publication date 2022/07
Summary 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