The “right” way is not always popular: comparison of surgeons’ perceptions during laparoscopic cholecystectomy for acute cholecystitis among experts from Japan, Korea and Taiwan

Taizo Hibi, Yukio Iwashita, Tetsuji Ohyama, Goro Honda, Masahiro Yoshida, 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, Fumihiko Miura, 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, Cheng Chung Wu, Naoyuki Toyota, Ryota Higuchi, Yoshiharu Nakamura, Yoshiaki Mizuguchi, Yutaka Takeda, Masahiro Ito, Shinji Norimizu, Shigetoshi Yamada, Naoki Matsumura, Junichi Shindoh, Hiroki Sunagawa, Takeshi Gocho, 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

15 Citations (Scopus)

Abstract

Background: Generally, surgeons’ perceptions of surgical safety are based on experience and institutional policy. Our recent pilot survey demonstrated that the acceptable duration of surgery and criteria for open conversion during laparoscopic cholecystectomy (LC) vary among workplaces. Methods: A web-based survey was distributed to 554 expert LC surgeons in Japan, Korea, and Taiwan. The questionnaire covered LC experience, safety measures and recognition of landmarks, decision-making regarding conversion to open/partial cholecystectomy and the implications of this decision. Overall responses were compared among nations, and then stratified by LC experience level (lifetime cases 200–499, 500–999, and ≥1,000). Results: The response rate was 92.6% (513/554); 67 surgeons with ≤199 LCs were excluded, and responses from 446 surgeons were analyzed. We observed significant differences among nations on almost all questions. Differences that remained after stratification by LC experience were on questions related to acceptable duration of surgery, adoption rates of intraoperative cholangiography, the “critical view of safety” technique, identification of Rouvière's sulcus, recognition of the SS-Inner layer theory, and intraoperative judgment to abandon conventional LC. Conclusions: Even among experts, surgeons’ perceptions during LC are workplace-dependent. A novel grading system of surgical difficulty and standardized LC procedures are paramount to generate high-level evidence.

Original languageEnglish
Pages (from-to)24-32
Number of pages9
JournalJournal of Hepato-Biliary-Pancreatic Sciences
Volume24
Issue number1
DOIs
Publication statusPublished - Jan 1 2017
Externally publishedYes

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Acute Cholecystitis
Laparoscopic Cholecystectomy
Korea
Taiwan
Japan
Safety
Workplace
Organizational Policy
Cholangiography
Surgeons
Cholecystectomy
Decision Making

Keywords

  • Acute cholecystitis
  • Critical view of safety
  • Laparoscopic cholecystectomy
  • SS-Inner theory
  • Surgical difficulty

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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; Kano, Nobuyasu; Kitano, Seigo; Tokumura, Hiromi; Yamashita, Yuichi; Watanabe, Goro; Nakagawa, Kunitoshi; Kimura, Taizo; Yamakawa, Tatsuo; Wakabayashi, Go; Endo, Itaru; Miyazaki, Masaru; Yamamoto, Masakazu.

In: Journal of Hepato-Biliary-Pancreatic Sciences, Vol. 24, No. 1, 01.01.2017, p. 24-32.

Research output: Contribution to journalArticle

Hibi, T, Iwashita, Y, Ohyama, T, Honda, G, Yoshida, M, Takada, T, Han, HS, Hwang, TL, Shinya, S, Suzuki, K, Umezawa, A, Yoon, YS, Choi, IS, Huang, WSW, Chen, KH, Miura, F, Watanabe, M, Abe, Y, Misawa, T, Nagakawa, Y, Yoon, DS, Jang, JY, Yu, HC, Ahn, KS, Kim, SC, Song, IS, Kim, JH, Yun, SS, Choi, SH, Jan, YY, Sheen-Chen, SM, Shan, YS, Ker, CG, Chan, DC, Wu, CC, Toyota, N, Higuchi, R, Nakamura, Y, Mizuguchi, Y, Takeda, Y, Ito, M, Norimizu, S, Yamada, S, Matsumura, N, Shindoh, J, Sunagawa, H, Gocho, T, Hasegawa, H, Rikiyama, T, Sata, N, Kano, N, Kitano, S, Tokumura, H, Yamashita, Y, Watanabe, G, Nakagawa, K, Kimura, T, Yamakawa, T, Wakabayashi, G, Endo, I, Miyazaki, M & Yamamoto, M 2017, 'The “right” way is not always popular: comparison of surgeons’ perceptions during laparoscopic cholecystectomy for acute cholecystitis among experts from Japan, Korea and Taiwan', Journal of Hepato-Biliary-Pancreatic Sciences, vol. 24, no. 1, pp. 24-32. https://doi.org/10.1002/jhbp.417
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 ; Kano, Nobuyasu ; Kitano, Seigo ; Tokumura, Hiromi ; Yamashita, Yuichi ; Watanabe, Goro ; Nakagawa, Kunitoshi ; Kimura, Taizo ; Yamakawa, Tatsuo ; Wakabayashi, Go ; Endo, Itaru ; Miyazaki, Masaru ; Yamamoto, Masakazu. / The “right” way is not always popular : comparison of surgeons’ perceptions during laparoscopic cholecystectomy for acute cholecystitis among experts from Japan, Korea and Taiwan. In: Journal of Hepato-Biliary-Pancreatic Sciences. 2017 ; Vol. 24, No. 1. pp. 24-32.
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abstract = "Background: Generally, surgeons’ perceptions of surgical safety are based on experience and institutional policy. Our recent pilot survey demonstrated that the acceptable duration of surgery and criteria for open conversion during laparoscopic cholecystectomy (LC) vary among workplaces. Methods: A web-based survey was distributed to 554 expert LC surgeons in Japan, Korea, and Taiwan. The questionnaire covered LC experience, safety measures and recognition of landmarks, decision-making regarding conversion to open/partial cholecystectomy and the implications of this decision. Overall responses were compared among nations, and then stratified by LC experience level (lifetime cases 200–499, 500–999, and ≥1,000). Results: The response rate was 92.6{\%} (513/554); 67 surgeons with ≤199 LCs were excluded, and responses from 446 surgeons were analyzed. We observed significant differences among nations on almost all questions. Differences that remained after stratification by LC experience were on questions related to acceptable duration of surgery, adoption rates of intraoperative cholangiography, the “critical view of safety” technique, identification of Rouvi{\`e}re's sulcus, recognition of the SS-Inner layer theory, and intraoperative judgment to abandon conventional LC. Conclusions: Even among experts, surgeons’ perceptions during LC are workplace-dependent. A novel grading system of surgical difficulty and standardized LC procedures are paramount to generate high-level evidence.",
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author = "Taizo Hibi and Yukio Iwashita and Tetsuji Ohyama and Goro Honda and Masahiro Yoshida and Tadahiro Takada and Han, {Ho Seong} and Hwang, {Tsann Long} and Satoshi Shinya and Kenji Suzuki and Akiko Umezawa and Yoon, {Yoo Seok} and Choi, {In Seok} and Huang, {Wayne Shih Wei} and Chen, {Kuo Hsin} and Fumihiko Miura and Manabu Watanabe and Yuta Abe and Takeyuki Misawa and Yuichi Nagakawa and Yoon, {Dong Sup} and Jang, {Jin Young} and Yu, {Hee Chul} and Ahn, {Keun Soo} and Kim, {Song Cheol} and Song, {In Sang} and Kim, {Ji Hoon} and Yun, {Sung Su} and Choi, {Seong Ho} and Jan, {Yi Yin} and Sheen-Chen, {Shyr Ming} and Shan, {Yan Shen} and Ker, {Chen Guo} and Chan, {De Chuan} and Wu, {Cheng Chung} and Naoyuki Toyota and Ryota Higuchi and Yoshiharu Nakamura and Yoshiaki Mizuguchi and Yutaka Takeda and Masahiro Ito and Shinji Norimizu and Shigetoshi Yamada and Naoki Matsumura and Junichi Shindoh and Hiroki Sunagawa and Takeshi Gocho and Hiroshi Hasegawa and Toshiki Rikiyama and Naohiro Sata and Nobuyasu Kano and Seigo Kitano and Hiromi Tokumura and Yuichi Yamashita and Goro Watanabe and Kunitoshi Nakagawa and Taizo Kimura and Tatsuo Yamakawa and Go Wakabayashi and Itaru Endo and Masaru Miyazaki and Masakazu Yamamoto",
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T2 - comparison of surgeons’ perceptions during laparoscopic cholecystectomy for acute cholecystitis among experts from Japan, Korea and Taiwan

AU - Hibi, Taizo

AU - Iwashita, Yukio

AU - Ohyama, Tetsuji

AU - Honda, Goro

AU - Yoshida, Masahiro

AU - Takada, Tadahiro

AU - Han, Ho Seong

AU - Hwang, Tsann Long

AU - Shinya, Satoshi

AU - Suzuki, Kenji

AU - Umezawa, Akiko

AU - Yoon, Yoo Seok

AU - Choi, In Seok

AU - Huang, Wayne Shih Wei

AU - Chen, Kuo Hsin

AU - Miura, Fumihiko

AU - Watanabe, Manabu

AU - Abe, Yuta

AU - Misawa, Takeyuki

AU - Nagakawa, Yuichi

AU - Yoon, Dong Sup

AU - Jang, Jin Young

AU - Yu, Hee Chul

AU - Ahn, Keun Soo

AU - Kim, Song Cheol

AU - Song, In Sang

AU - Kim, Ji Hoon

AU - Yun, Sung Su

AU - Choi, Seong Ho

AU - Jan, Yi Yin

AU - Sheen-Chen, Shyr Ming

AU - Shan, Yan Shen

AU - Ker, Chen Guo

AU - Chan, De Chuan

AU - Wu, Cheng Chung

AU - Toyota, Naoyuki

AU - Higuchi, Ryota

AU - Nakamura, Yoshiharu

AU - Mizuguchi, Yoshiaki

AU - Takeda, Yutaka

AU - Ito, Masahiro

AU - Norimizu, Shinji

AU - Yamada, Shigetoshi

AU - Matsumura, Naoki

AU - Shindoh, Junichi

AU - Sunagawa, Hiroki

AU - Gocho, Takeshi

AU - Hasegawa, Hiroshi

AU - Rikiyama, Toshiki

AU - Sata, Naohiro

AU - Kano, Nobuyasu

AU - Kitano, Seigo

AU - Tokumura, Hiromi

AU - Yamashita, Yuichi

AU - Watanabe, Goro

AU - Nakagawa, Kunitoshi

AU - Kimura, Taizo

AU - Yamakawa, Tatsuo

AU - Wakabayashi, Go

AU - Endo, Itaru

AU - Miyazaki, Masaru

AU - Yamamoto, Masakazu

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background: Generally, surgeons’ perceptions of surgical safety are based on experience and institutional policy. Our recent pilot survey demonstrated that the acceptable duration of surgery and criteria for open conversion during laparoscopic cholecystectomy (LC) vary among workplaces. Methods: A web-based survey was distributed to 554 expert LC surgeons in Japan, Korea, and Taiwan. The questionnaire covered LC experience, safety measures and recognition of landmarks, decision-making regarding conversion to open/partial cholecystectomy and the implications of this decision. Overall responses were compared among nations, and then stratified by LC experience level (lifetime cases 200–499, 500–999, and ≥1,000). Results: The response rate was 92.6% (513/554); 67 surgeons with ≤199 LCs were excluded, and responses from 446 surgeons were analyzed. We observed significant differences among nations on almost all questions. Differences that remained after stratification by LC experience were on questions related to acceptable duration of surgery, adoption rates of intraoperative cholangiography, the “critical view of safety” technique, identification of Rouvière's sulcus, recognition of the SS-Inner layer theory, and intraoperative judgment to abandon conventional LC. Conclusions: Even among experts, surgeons’ perceptions during LC are workplace-dependent. A novel grading system of surgical difficulty and standardized LC procedures are paramount to generate high-level evidence.

AB - Background: Generally, surgeons’ perceptions of surgical safety are based on experience and institutional policy. Our recent pilot survey demonstrated that the acceptable duration of surgery and criteria for open conversion during laparoscopic cholecystectomy (LC) vary among workplaces. Methods: A web-based survey was distributed to 554 expert LC surgeons in Japan, Korea, and Taiwan. The questionnaire covered LC experience, safety measures and recognition of landmarks, decision-making regarding conversion to open/partial cholecystectomy and the implications of this decision. Overall responses were compared among nations, and then stratified by LC experience level (lifetime cases 200–499, 500–999, and ≥1,000). Results: The response rate was 92.6% (513/554); 67 surgeons with ≤199 LCs were excluded, and responses from 446 surgeons were analyzed. We observed significant differences among nations on almost all questions. Differences that remained after stratification by LC experience were on questions related to acceptable duration of surgery, adoption rates of intraoperative cholangiography, the “critical view of safety” technique, identification of Rouvière's sulcus, recognition of the SS-Inner layer theory, and intraoperative judgment to abandon conventional LC. Conclusions: Even among experts, surgeons’ perceptions during LC are workplace-dependent. A novel grading system of surgical difficulty and standardized LC procedures are paramount to generate high-level evidence.

KW - Acute cholecystitis

KW - Critical view of safety

KW - Laparoscopic cholecystectomy

KW - SS-Inner theory

KW - Surgical difficulty

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