Development of a novel intraoperative difficulty score for minimally invasive cholecystectomy.

HPB : the Official Journal of the International Hepato Pancreato Biliary Association
Brittany CalkinsChet W Hammill

Abstract

The rate of biliary injuries from minimally invasive cholecystectomy has remained high for over two decades. To improve outcomes there are multiple bail-out methods described, including aborting the procedure, converting to open, or performing a sub-total cholecystectomy. However, the intraoperative difficulty threshold for when a bail-out method should be implemented is poorly understood. From 1/2014 to 2/2019 cholecystectomy videos were collected, de-identified, edited to include the 2-3 minutes when the gallbladder was first visualized, and accelerated. They were then rated on a 5-point difficulty scale. Inter-coder reliability was evaluated using Krippendorff's alpha and regression models were used to evaluate the scores ability to predict the need for a bail-out technique. 62 videos were analyzed with a median length after editing of 37.5 (29.0-43.3) seconds. A median time of 46.2 (38.3-53.4) seconds was required for grading. The bail-out rate was 42.9%. The inter-coder reliability between 2 surgeons and 8 non-clinical reviewers was 0.675 with an average difficulty score of 3.0 (SD = 1.01). Regression models showed that the scale was able to significantly predict conversion (β=0.56,p<.01). This novel difficulty score was a...Continue Reading

References

Jan 24, 2003·Journal of Hepato-biliary-pancreatic Surgery·Steven M Strasberg
Sep 27, 2005·Journal of the American College of Surgeons·Steven M Strasberg
May 4, 2006·The British Journal of Surgery·M S HobbsS C Ridout
Jul 18, 2006·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Benjie Tang, Alfred Cuschieri
Sep 15, 2007·Gastroenterology·Charles M Vollmer, Mark P Callery
Oct 31, 2008·ANZ Journal of Surgery·Wei-Jie ZhangZhi-Tao Dong
Nov 15, 2008·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·C AvgerinosC Dervenis
Mar 6, 2010·JSLS : Journal of the Society of Laparoendoscopic Surgeons·Ashfaq ChandioFuad Aftab
Mar 6, 2013·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Matthew P LandmanC Wright Pinson
Sep 17, 2017·Surgical Endoscopy·Meredith BarrettDana A Telem
Jan 9, 2018·Journal of the American College of Surgeons·Zhi Ven FongUNKNOWN California Cholecystectomy Group
Oct 1, 2019·Trauma Surgery & Acute Care Open·Emily FletcherAkpofure Peter Ekeh

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