抄録
Bile duct injury (BDI) during laparoscopic cholecystectomy remains a serious iatrogenic surgical complication. BDI most often occurs as a result of misidentification of the anatomy; however, clinical evidence on its precise mechanism and surgeons’ perceptions is scarce. Surgeons from Japan, Korea, Taiwan, and the USA, etc. (n = 614) participated in a questionnaire regarding their BDI experience and near-misses; and perceptions on landmarks, intraoperative findings, and surgical techniques. Respondents voted for a Delphi process and graded each item on a five-point scale. The consensus was built when ≥80% of overall responses were 4 or 5. Response rates for the first- and second-round Delphi were 60.6% and 74.9%, respectively. Misidentification of local anatomy accounted for 76.2% of BDI. Final consensus was reached on: (1) Effective retraction of the gallbladder, (2) Always obtaining critical view of safety, and (3) Avoiding excessive use of electrocautery/clipping as vital procedures; and (4) Calot's triangle area and (5) Critical view of safety as important landmarks. For (6) Impacted gallstone and (7) Severe fibrosis/scarring in Calot's triangle, bail-out procedures may be indicated. A consensus was reached among expert surgeons on relevant landmarks and intraoperative findings and appropriate surgical techniques to avoid BDI.
| 元の言語 | 英語 |
|---|---|
| ページ（範囲） | 591-602 |
| ページ数 | 12 |
| ジャーナル | Journal of Hepato-Biliary-Pancreatic Sciences |
| 巻 | 24 |
| 発行部数 | 11 |
| DOI | |
| 出版物ステータス | 出版済み - 11 1 2017 |
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All Science Journal Classification (ASJC) codes
- Surgery
- Hepatology
これを引用
Delphi consensus on bile duct injuries during laparoscopic cholecystectomy : an evolutionary cul-de-sac or the birth pangs of a new technical framework? / Iwashita, Yukio; Hibi, Taizo; Ohyama, Tetsuji; Umezawa, Akiko; Takada, Tadahiro; Strasberg, Steven M.; Asbun, Horacio J.; Pitt, Henry A.; Han, Ho Seong; Hwang, Tsann Long; Suzuki, Kenji; Yoon, Yoo Seok; Choi, In Seok; Yoon, Dong Sup; Huang, Wayne Shih Wei; Yoshida, Masahiro; Wakabayashi, Go; Miura, Fumihiko; Okamoto, Kohji; Endo, Itaru; de Santibañes, Eduardo; Giménez, Mariano Eduardo; Windsor, John A.; Garden, O. James; Gouma, Dirk J.; Cherqui, Daniel; Belli, Giulio; Dervenis, Christos; Deziel, Daniel J.; Jonas, Eduard; Jagannath, Palepu; Supe, Avinash Nivritti; Singh, Harjit; Liau, Kui Hin; Chen, Xiao Ping; Chan, Angus C.W.; Lau, Wan Yee; Fan, Sheung Tat; Chen, Miin Fu; Kim, Myung Hwan; Honda, Goro; Sugioka, Atsushi; Asai, Koji; Wada, Keita; Mori, Yasuhisa; Higuchi, Ryota; Misawa, Takeyuki; Watanabe, Manabu; Matsumura, Naoki; Rikiyama, Toshiki; Sata, Naohiro; Kano, Nobuyasu; Tokumura, Hiromi; Kimura, Taizo; Kitano, Seigo; Inomata, Masafumi; Hirata, Koichi; Sumiyama, Yoshinobu; Inui, Kazuo; Yamamoto, Masakazu.
：: Journal of Hepato-Biliary-Pancreatic Sciences, 巻 24, 番号 11, 01.11.2017, p. 591-602.研究成果: ジャーナルへの寄稿 › 記事
}
TY - JOUR
T1 - Delphi consensus on bile duct injuries during laparoscopic cholecystectomy
T2 - an evolutionary cul-de-sac or the birth pangs of a new technical framework?
AU - Iwashita, Yukio
AU - Hibi, Taizo
AU - Ohyama, Tetsuji
AU - Umezawa, Akiko
AU - Takada, Tadahiro
AU - Strasberg, Steven M.
AU - Asbun, Horacio J.
AU - Pitt, Henry A.
AU - Han, Ho Seong
AU - Hwang, Tsann Long
AU - Suzuki, Kenji
AU - Yoon, Yoo Seok
AU - Choi, In Seok
AU - Yoon, Dong Sup
AU - Huang, Wayne Shih Wei
AU - Yoshida, Masahiro
AU - Wakabayashi, Go
AU - Miura, Fumihiko
AU - Okamoto, Kohji
AU - Endo, Itaru
AU - de Santibañes, Eduardo
AU - Giménez, Mariano Eduardo
AU - Windsor, John A.
AU - Garden, O. James
AU - Gouma, Dirk J.
AU - Cherqui, Daniel
AU - Belli, Giulio
AU - Dervenis, Christos
AU - Deziel, Daniel J.
AU - Jonas, Eduard
AU - Jagannath, Palepu
AU - Supe, Avinash Nivritti
AU - Singh, Harjit
AU - Liau, Kui Hin
AU - Chen, Xiao Ping
AU - Chan, Angus C.W.
AU - Lau, Wan Yee
AU - Fan, Sheung Tat
AU - Chen, Miin Fu
AU - Kim, Myung Hwan
AU - Honda, Goro
AU - Sugioka, Atsushi
AU - Asai, Koji
AU - Wada, Keita
AU - Mori, Yasuhisa
AU - Higuchi, Ryota
AU - Misawa, Takeyuki
AU - Watanabe, Manabu
AU - Matsumura, Naoki
AU - Rikiyama, Toshiki
AU - Sata, Naohiro
AU - Kano, Nobuyasu
AU - Tokumura, Hiromi
AU - Kimura, Taizo
AU - Kitano, Seigo
AU - Inomata, Masafumi
AU - Hirata, Koichi
AU - Sumiyama, Yoshinobu
AU - Inui, Kazuo
AU - Yamamoto, Masakazu
PY - 2017/11/1
Y1 - 2017/11/1
N2 - Bile duct injury (BDI) during laparoscopic cholecystectomy remains a serious iatrogenic surgical complication. BDI most often occurs as a result of misidentification of the anatomy; however, clinical evidence on its precise mechanism and surgeons’ perceptions is scarce. Surgeons from Japan, Korea, Taiwan, and the USA, etc. (n = 614) participated in a questionnaire regarding their BDI experience and near-misses; and perceptions on landmarks, intraoperative findings, and surgical techniques. Respondents voted for a Delphi process and graded each item on a five-point scale. The consensus was built when ≥80% of overall responses were 4 or 5. Response rates for the first- and second-round Delphi were 60.6% and 74.9%, respectively. Misidentification of local anatomy accounted for 76.2% of BDI. Final consensus was reached on: (1) Effective retraction of the gallbladder, (2) Always obtaining critical view of safety, and (3) Avoiding excessive use of electrocautery/clipping as vital procedures; and (4) Calot's triangle area and (5) Critical view of safety as important landmarks. For (6) Impacted gallstone and (7) Severe fibrosis/scarring in Calot's triangle, bail-out procedures may be indicated. A consensus was reached among expert surgeons on relevant landmarks and intraoperative findings and appropriate surgical techniques to avoid BDI.
AB - Bile duct injury (BDI) during laparoscopic cholecystectomy remains a serious iatrogenic surgical complication. BDI most often occurs as a result of misidentification of the anatomy; however, clinical evidence on its precise mechanism and surgeons’ perceptions is scarce. Surgeons from Japan, Korea, Taiwan, and the USA, etc. (n = 614) participated in a questionnaire regarding their BDI experience and near-misses; and perceptions on landmarks, intraoperative findings, and surgical techniques. Respondents voted for a Delphi process and graded each item on a five-point scale. The consensus was built when ≥80% of overall responses were 4 or 5. Response rates for the first- and second-round Delphi were 60.6% and 74.9%, respectively. Misidentification of local anatomy accounted for 76.2% of BDI. Final consensus was reached on: (1) Effective retraction of the gallbladder, (2) Always obtaining critical view of safety, and (3) Avoiding excessive use of electrocautery/clipping as vital procedures; and (4) Calot's triangle area and (5) Critical view of safety as important landmarks. For (6) Impacted gallstone and (7) Severe fibrosis/scarring in Calot's triangle, bail-out procedures may be indicated. A consensus was reached among expert surgeons on relevant landmarks and intraoperative findings and appropriate surgical techniques to avoid BDI.
UR - http://www.scopus.com/inward/record.url?scp=85032734394&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85032734394&partnerID=8YFLogxK
U2 - 10.1002/jhbp.503
DO - 10.1002/jhbp.503
M3 - Article
VL - 24
SP - 591
EP - 602
JO - Journal of Hepato-Biliary-Pancreatic Sciences
JF - Journal of Hepato-Biliary-Pancreatic Sciences
SN - 1868-6974
IS - 11
ER -