• Masanao Kurata, Yukio Iwashita, Tetsuji Ohyama, Itaru Endo, Taizo Hibi, Akiko Umezawa, Kenji Suzuki, Manabu Watanabe, Koji Asai, Yasuhisa Mori, Masaharu Higashida, Yusuke Kumamoto, Junichi Shindoh, Masahiro Yoshida, Goro Honda, Takeyuki Misawa, Yuta Abe, Yuichi Nagakawa, Naoyuki Toyota, Shigetoshi Yamada, Shinji Norimizu, Naoki Matsumura, Naohiro Sata, Hiroki Sunagawa, Masahiro Ito, Yutaka Takeda, Yoshiharu Nakamura, Toshiki Rikiyama, Ryota Higuchi, Takeshi Gocho, Kimihiko Ueno, Yuko Kumagai, Shingo Kanaji, Tadahiro Takada, and Masakazu Yamamoto.
• Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
• J Hepatobiliary Pancreat Sci. 2021 Mar 1; 28 (3): 255-262.

BackgroundTo explore best practices for acute cholecystitis, it is necessary to construct a system to assess the difficulty of laparoscopic cholecystectomy (LC) based on intraoperative findings. In this study, multiple evaluators assessed videos of LC to assemble a library of typical video clips for 25 intraoperative findings.MethodsWe have previously identified 25 items that contribute to surgical difficulty in LC. For each item, roughly 30-second video clips were submitted from videos of LC performed at member institutions. We then selected one typical video from the collected clips based on simple tabulation of the instances of agreement. Inter-rater agreement was assessed with Fleiss's κ and Gwet's agreement coefficient (AC).ResultsExcept in the case of two assessment items ("edematous change" and "easy bleeding"), κ or AC significantly exceeded 0.5 and the typical videos were judged to be applicable. For the two remaining items, the evaluation was repeated after clarifying the definitions of positive and negative findings. Eventually, they were recognized as typical. The completed video clip library contains 31 clips and is divided into five categories (http://www.jshbps.jp/modules/project/index.php?content_id=13).ConclusionsThis clip library may be highly useful in clinical settings as a more objective standard for assessing surgical difficulty in LC.© 2020 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

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