An opportunity in difficulty: Japan-Korea-Taiwan expert Delphi consensus on surgical difficulty during laparoscopic cholecystectomy

被引：48

作者：

Iwashita, Yukio ^{[1
]}

Hibi, Taizo ^{[2
]}

Ohyama, Tetsuji ^{[3
]}

Honda, Goro ^{[4
]}

Yoshida, Masahiro ^{[5
]}

Miura, Fumihiko ^{[6
]}

Takada, Tadahiro ^{[6
]}

Han, Ho-Seong ^{[7
]}

Hwang, Tsann-Long ^{[8
]}

Shinya, Satoshi ^{[9
]}

Suzuki, Kenji ^{[10
]}

Umezawa, Akiko ^{[11
]}

Yoon, Yoo-Seok ^{[7
]}

Choi, In-Seok ^{[12
]}

Huang, Wayne Shih-Wei ^{[13
]}

Chen, Kuo-Hsin ^{[14
,15
,16
]}

Watanabe, Manabu ^{[17
]}

Abe, Yuta ^{[2
]}

Misawa, Takeyuki ^{[18
]}

Nagakawa, Yuichi ^{[19
]}

Yoon, Dong-Sup ^{[20
]}

Jang, Jin-Young ^{[21
]}

Yu, Hee Chul ^{[22
]}

Ahn, Keun Soo ^{[23
]}

Kim, Song Cheol ^{[24
,25
]}

Song, In Sang ^{[26
]}

Kim, Ji Hoon ^{[27
]}

Yun, Sung Su ^{[28
]}

Choi, Seong Ho ^{[29
]}

Jan, Yi-Yin ^{[8
]}

Shan, Yan-Shen ^{[30
]}

Ker, Chen-Guo ^{[31
]}

Chan, De-Chuan ^{[32
]}

Wu, Cheng-Chung ^{[33
]}

Lee, King-Teh ^{[34
]}

Toyota, Naoyuki ^{[35
]}

Higuchi, Ryota ^{[36
]}

Nakamura, Yoshiharu ^{[37
]}

Mizuguchi, Yoshiaki ^{[38
]}

Takeda, Yutaka ^{[39
]}

Ito, Masahiro ^{[40
]}

Norimizu, Shinji ^{[41
]}

Yamada, Shigetoshi ^{[42
]}

Matsumura, Naoki ^{[43
]}

Shindoh, Junichi ^{[44
]}

Sunagawa, Hiroki ^{[45
]}

Gocho, Takeshi ^{[46
]}

Hasegawa, Hiroshi ^{[47
]}

Rikiyama, Toshiki ^{[48
]}

Sata, Naohiro ^{[49
]}

机构：

[1] Oita Univ, Fac Med, Dept Gastroenterol & Pediat Surg, Oita, Japan

[2] Keio Univ, Dept Surg, Sch Med, Tokyo, Japan

[3] Oita Univ, Dept Clin Stat & Data Management, Fac Med, Oita, Japan

[4] Tokyo Metropolitan Komagome Hosp, Dept Surg, Tokyo, Japan

[5] Int Univ Hlth & Welf, Chemotherapy Res Inst, Dept Hemodialysis & Surg, Chiba, Japan

[6] Teikyo Univ, Dept Surg, Sch Med, Tokyo, Japan

[7] Seoul Natl Univ, Dept Surg, Bundang Hosp, Seongnam Si, South Korea

[8] Lin Kou Chang Gung Mem Hosp, Div Gen Surg, Tayuan, Taiwan

[9] Fukuoka Kieikai Hosp, Dept Surg, Fukuoka, Japan

[10] Fujinomiya City Gen Hosp, Dept Surg, Shizuoka, Japan

[11] Minimally Invas Surg Ctr, Yotsuya Med Cube, Tokyo, Japan

[12] Konyang Univ Hosp, Dept Surg, Daejeon, South Korea

[13] Show Chwan Mem Hosp, Dept Surg, Changhua, Taiwan

[14] Far Eastern Mem Hosp, Dept Surg, New Taipei, Tauyuan, Taiwan

[15] Far Eastern Mem Hosp, Dept Elect Engn, New Taipei, Tauyuan, Taiwan

[16] Yuan Ze Univ, New Taipei, Tauyuan, Taiwan

[17] Toho Univ, Dept Surg, Ohashi Med Ctr, Tokyo, Japan

[18] Jikei Univ, Dept Surg, Kashiwa Hosp, Chiba, Japan

[19] Tokyo Med Univ, Dept Gastrointestinal & Pediat Surg, Tokyo, Japan

[20] Yonsei Univ, Dept Surg, Gangnam Severance Hosp, Seoul, South Korea

[21] Seoul Natl Univ Hosp, Dept Surg, Seoul, South Korea

[22] Chonbuk Natl Univ Hosp, Dept Surg, Jeonju, South Korea

[23] Keimyung Univ, Dept Surg, Dongsan Med Ctr, Daegu, South Korea

[24] Univ Ulsan, Dept Surg, Coll Med, Seoul, South Korea

[25] Asan Med Ctr, Seoul, South Korea

[26] Chungnam Natl Univ Hosp, Dept Surg, Daejeon, South Korea

[27] Eulji Univ Hosp, Dept Surg, Daejeon, South Korea

[28] Yeungnam Univ, Dept Surg, Daegu, South Korea

[29] Sungkyunkwan Univ, Dept Surg, Seoul, South Korea

[30] Natl Cheng Kung Univ Hosp, Dept Surg, Tainan, Taiwan

[31] Yuans Gen Hosp, Dept Surg, Kaohsiung, Taiwan

[32] Triserv Gen Hosp, Div Gen Surg, Natl Def Med Ctr, Taipei, Taiwan

[33] Taichung Vet Gen Hosp, Dept Surg, Taichung, Taiwan

[34] Kaohsiung Med Univ Hosp, Dept Surg, Kaohsiung, Taiwan

[35] Musashino Tokushukai Hosp, Dept Surg, Tokyo, Japan

[36] Tokyo Womens Med Univ, Inst Gastroenterol, Dept Surg, Tokyo, Japan

[37] Nippon Med Sch, Dept Gastrointestinal & Hepatobiliarypancreat Sur, Tokyo, Japan

[38] Nippon Med Sch, Dept Surg, Tokyo, Japan

[39] Kansai Rosai Hosp, Dept Surg, Amagasaki, Hyogo, Japan

[40] Fujita Hlth Univ, Dept Gen & Pancreat Surg, Qual & Safety Healthcare, Toyoake, Aichi, Japan

[41] Nagoya Daini Red Cross Hosp, Dept Surg, Nagoya, Aichi, Japan

[42] Kameda Med Ctr, Dept Surg, Chiba, Japan

[43] Tohoku Rosai Hosp, Dept Surg, Sendai, Miyagi, Japan

[44] Toranomon Gen Hosp, Dept Digest Surg, Tokyo, Japan

[45] St Lukes Int Hosp, Dept Surg Gastroenterol, Tokyo, Japan

[46] Jikei Univ, Dept Surg, Sch Med, Tokyo, Japan

[47] Tokai Hosp, Laparoscop Surg Ctr, Nagoya, Aichi, Japan

[48] Jichi Med Univ, Saitama Med Ctr, Dept Surg, Saitama, Japan

[49] Jichi Med Univ, Dept Surg, Shimotsuke, Tochigi, Japan

[50] Chiba Tokushukai Hosp, Director, Chiba, Japan

来源：

JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES | 2017年 / 24卷 / 04期

关键词：

Acute cholecystitis; Delphi consensus; Laparoscopic cholecystectomy; Surgical difficulty; PREDICT TECHNICAL DIFFICULTIES; ACUTE CHOLECYSTITIS; RISK-FACTORS; CONVERSION; GALLBLADDER; CHOLECYSTOSTOMY; SYSTEM; SCORE;

D O I：

10.1002/jhbp.440

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

BackgroundWe 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. MethodsSurgeons 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. ResultsResponse 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. ConclusionsA Delphi consensus was reached among expert LC surgeons on the impact of intraoperative findings on surgical difficulty.

引用

页码：191 / 198

页数：8

共 24 条

[1] What are the appropriate indicators of surgical difficulty during laparoscopic cholecystectomy? Results from a Japan-Korea-Taiwan multinational survey
Iwashita, Yukio
Ohyama, Tetsuji
Honda, Goro
Hibi, Taizo
Yoshida, Masahiro
Miura, Fumihiko
Takada, Tadahiro
Han, Ho-Seong
Hwang, Tsann-Long
Shinya, Satoshi
Suzuki, Kenji
Umezawa, Akiko
Yoon, Yoo-Seok
Choi, In-Seok
Huang, Wayne Shih-Wei
Chen, Kuo-Hsin
Watanabe, Manabu
Abe, Yuta
Misawa, Takeyuki
Nagakawa, Yuichi
Yoon, Dong-Sup
Jang, Jin-Young
Yu, Hee Chul
Ahn, Keun Soo
Kim, Song Cheol
Song, In Sang
Kim, Ji Hoon
Yun, Sung Su
Choi, Seong Ho
Jan, Yi-Yin
Sheen-Chen, Shyr-Ming
Shan, Yan-Shen
Ker, Chen-Guo
Chan, De-Chuan
Lee, King-Teh
Toyota, Naoyuki
Higuchi, Ryota
Nakamura, Yoshiharu
Mizuguchi, Yoshiaki
Takeda, Yutaka
Ito, Masahiro
Norimizu, Shinji
Yamada, Shigetoshi
Matsumura, Naoki
Shindoh, Junichi
Sunagawa, Hiroki
Hasegawa, Hiroshi
Rikiyama, Toshiki
Sata, Naohiro
Kano, Nobuyasu
JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES, 2016, 23 (09) : 533 - 547
[2] Application of a novel surgical difficulty grading system during laparoscopic cholecystectomy
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
Honda, Goro
Misawa, Takeyuki
Abe, Yuta
Nagakawa, Yuichi
Toyota, Naoyuki
Yamada, Shigetoshi
Norimizu, Shinji
Matsumura, Naoki
Sata, Naohiro
Sunagawa, Hiroki
Ito, Masahiro
Takeda, Yutaka
Nakamura, Yoshiharu
Rikiyama, Toshiki
Higuchi, Ryota
Gocho, Takeshi
Honma, Yuki
Hirashita, Teijiro
Kanemoto, Hideyuki
Nozawa, Masayuki
Watanabe, Yusuke
Kohga, Atsushi
Yazawa, Takehisa
Tajima, Hiroshi
Nakahira, Shin
Asaoka, Tadafumi
Yoshioka, Ryuji
Fukuzawa, Junya
Fujioka, Shuichi
Hata, Daigo
Haruta, Hidenori
Asano, Yukio
Nomura, Ryohei
Matsumoto, Joe
Kameyama, Noriaki
Miyoshi, Atsushi
JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES, 2022, 29 (07) : 758 - 767
[3] The "right" way is not always popular: comparison of surgeons' perceptions during laparoscopic cholecystectomy for acute cholecystitis among experts from Japan, Korea and Taiwan
Hibi, Taizo
Iwashita, Yukio
Ohyama, Tetsuji
Honda, Goro
Yoshida, Masahiro
Takada, Tadahiro
Han, Ho-Seong
Hwang, Tsann-Long
Shinya, Satoshi
Suzuki, Kenji
Umezawa, Akiko
Yoon, Yoo-Seok
Choi, In-Seok
Huang, Wayne Shih-Wei
Chen, Kuo-Hsin
Miura, Fumihiko
Watanabe, Manabu
Abe, Yuta
Misawa, Takeyuki
Nagakawa, Yuichi
Yoon, Dong-Sup
Jang, Jin-Young
Yu, Hee Chul
Ahn, Keun Soo
Kim, Song Cheol
Song, In Sang
Kim, Ji Hoon
Yun, Sung Su
Choi, Seong Ho
Jan, Yi-Yin
Sheen-Chen, Shyr-Ming
Shan, Yan-Shen
Ker, Chen-Guo
Chan, De-Chuan
Wu, Cheng-Chung
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
JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES, 2017, 24 (01) : 24 - 32
[4] Usefulness of preoperative drip infusion cholangiography with computed tomography for predicting surgical difficulty during laparoscopic cholecystectomy
Nakazawa, Akiko
Akamatsu, Nobuhisa
Miyata, Yoichi
Komagome, Masahiko
Maki, Akira
Arita, Junichi
Ishizawa, Takeaki
Kaneko, Junichi
Beck, Yoshifumi
Hasegawa, Kiyoshi
JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES, 2020, 27 (06) : 315 - 323
[5] Preoperative difficulty factors in delayed laparoscopic cholecystectomy: Tokyo Guidelines 2018 surgical difficulty score analysis
Naito, Kei
Suda, Kotaro
Shinoda, Kimio
Hashiba, Takahiro
Sano, Wataru
Chiku, Tsuyoshi
Ando, Katsuhiko
Ohtsuka, Masayuki
ASIAN JOURNAL OF ENDOSCOPIC SURGERY, 2024, 17 (02)
[6] New Scoring System for Prediction of Surgical Difficulty During Laparoscopic Cholecystectomy After Percutaneous Transhepatic Gallbladder Drainage
Matsumoto, Michinori
Abe, Kyohei
Futagawa, Yasuro
Furukawa, Kenei
Haruki, Koichiro
Onda, Shinji
Kurogochi, Takanori
Takeuchi, Nana
Okamoto, Tomoyoshi
Ikegami, Toru
ANNALS OF GASTROENTEROLOGICAL SURGERY, 2022, 6 (02): : 296 - 306
[7] Prediction of intraoperative surgical difficulty during laparoscopic cholecystectomy using drip infusion cholangiography with computed tomography
Fujinaga, Atsuro
Hirashita, Teijiro
Endo, Yuichi
Orimoto, Hiroki
Amano, Shota
Kawamura, Masahiro
Kawasaki, Takahide
Masuda, Takashi
Inomata, Masafumi
JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES, 2024, 31 (09) : 637 - 646
[8] Assembling a library of typical surgery video clips to construct a system for assessing the surgical difficulty of laparoscopic cholecystectomy
Kurata, Masanao
Iwashita, Yukio
Ohyama, Tetsuji
Endo, Itaru
Hibi, Taizo
Umezawa, Akiko
Suzuki, Kenji
Watanabe, Manabu
Asai, Koji
Mori, Yasuhisa
Higashida, Masaharu
Kumamoto, Yusuke
Shindoh, Junichi
Yoshida, Masahiro
Honda, Goro
Misawa, Takeyuki
Abe, Yuta
Nagakawa, Yuichi
Toyota, Naoyuki
Yamada, Shigetoshi
Norimizu, Shinji
Matsumura, Naoki
Sata, Naohiro
Sunagawa, Hiroki
Ito, Masahiro
Takeda, Yutaka
Nakamura, Yoshiharu
Rikiyama, Toshiki
Higuchi, Ryota
Gocho, Takeshi
Ueno, Kimihiko
Kumagai, Yuko
Kanaji, Shingo
Takada, Tadahiro
Yamamoto, Masakazu
JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES, 2021, 28 (03) : 255 - 262
[9] Validation of a surgical difficulty grading system in laparoscopic cholecystectomy for acute cholecystitis
Asai, Koji
Ohyama, Tetsuji
Watanabe, Manabu
Moriyama, Hodaka
Kujiraoka, Manabu
Watanabe, Ryutaro
Shigeta, Kenta
Kakizaki, Nanako
Hagiwara, Osahiko
Saida, Yoshihisa
JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES, 2024, 31 (02) : 80 - 88
[10] Prediction of the Surgical Difficulty of Single-port Laparoscopic Cholecystectomy
Iwashita, Yukio
Yasuda, Kazuhiro
Ohta, Masayuki
Hirashita, Teijiro
Masuda, Takashi
Eguchi, Hidetoshi
Yada, Kazuhiro
Kitano, Seigo
SURGICAL LAPAROSCOPY ENDOSCOPY & PERCUTANEOUS TECHNIQUES, 2012, 22 (06) : 514 - 517

← 1 2 3 →