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

13 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 - Sep 1 2016
Externally publishedYes

Fingerprint

Laparoscopic Cholecystectomy
Korea
Taiwan
Japan
Cholecystectomy
Gallbladder
Surveys and Questionnaires
Inflammation
Safety
Surgeons

Keywords

  • Critical view of safety
  • Laparoscopic cholecystectomy
  • Nominal group technique
  • SS-Inner theory
  • Surgical difficulty

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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; 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. 23, No. 9, 01.09.2016, p. 533-547.

Research output: Contribution to journalArticle

Iwashita, Y, Ohyama, T, Honda, G, Hibi, T, Yoshida, M, Miura, F, Takada, T, Han, HS, Hwang, TL, Shinya, S, Suzuki, K, Umezawa, A, Yoon, YS, Choi, IS, Huang, WSW, Chen, KH, 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, Lee, KT, Toyota, N, Higuchi, R, Nakamura, Y, Mizuguchi, Y, Takeda, Y, Ito, M, Norimizu, S, Yamada, S, Matsumura, N, Shindoh, J, Sunagawa, H, 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 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, vol. 23, no. 9, pp. 533-547. https://doi.org/10.1002/jhbp.375
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 ; Kitano, Seigo ; Tokumura, Hiromi ; Yamashita, Yuichi ; Watanabe, Goro ; Nakagawa, Kunitoshi ; Kimura, Taizo ; Yamakawa, Tatsuo ; Wakabayashi, Go ; Endo, Itaru ; Miyazaki, Masaru ; Yamamoto, Masakazu. / What are the appropriate indicators of surgical difficulty during laparoscopic cholecystectomy? Results from a Japan-Korea-Taiwan multinational survey. In: Journal of Hepato-Biliary-Pancreatic Sciences. 2016 ; Vol. 23, No. 9. pp. 533-547.
@article{9a3a1b9eac084b84b6736629e3b7b87a,
title = "What are the appropriate indicators of surgical difficulty during laparoscopic cholecystectomy? Results from a Japan-Korea-Taiwan multinational survey",
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.",
keywords = "Critical view of safety, Laparoscopic cholecystectomy, Nominal group technique, SS-Inner theory, Surgical difficulty",
author = "Yukio Iwashita and Tetsuji Ohyama and Goro Honda and Taizo Hibi and Masahiro Yoshida and Fumihiko Miura 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 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 Lee, {King Teh} 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 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",
year = "2016",
month = "9",
day = "1",
doi = "10.1002/jhbp.375",
language = "English",
volume = "23",
pages = "533--547",
journal = "Journal of Hepato-Biliary-Pancreatic Sciences",
issn = "1868-6974",
publisher = "Springer Verlag",
number = "9",

}

TY - JOUR

T1 - What are the appropriate indicators of surgical difficulty during laparoscopic cholecystectomy? Results from a Japan-Korea-Taiwan multinational survey

AU - Iwashita, Yukio

AU - Ohyama, Tetsuji

AU - Honda, Goro

AU - Hibi, Taizo

AU - Yoshida, Masahiro

AU - Miura, Fumihiko

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 - 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 - Lee, King Teh

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 - 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 - 2016/9/1

Y1 - 2016/9/1

N2 - 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.

AB - 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.

KW - Critical view of safety

KW - Laparoscopic cholecystectomy

KW - Nominal group technique

KW - SS-Inner theory

KW - Surgical difficulty

UR - http://www.scopus.com/inward/record.url?scp=84987704794&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84987704794&partnerID=8YFLogxK

U2 - 10.1002/jhbp.375

DO - 10.1002/jhbp.375

M3 - Article

C2 - 27490841

AN - SCOPUS:84987704794

VL - 23

SP - 533

EP - 547

JO - Journal of Hepato-Biliary-Pancreatic Sciences

JF - Journal of Hepato-Biliary-Pancreatic Sciences

SN - 1868-6974

IS - 9

ER -