日本語フィールド
著者：Egawa N, Miyoshi A, Manabe T, Sadashima E, Koga H, Sato H, Ikeda O, Tanaka T, Kitahara K, Noshiro H題名：Clinical evaluation of a surgical difficulty score for laparoscopic cholecystectomy for acute cholecystitis proposed in the Tokyo Guidelines 2018発表情報：J Hepatobiliary Pancreat Sci 巻: 30 号: 5 ページ: 625-632キーワード：Tokyo Guidelines 2018; acute cholecystitis; laparoscopic cholecystectomy; subtotal cholecystectomy; surgical difficulty score概要：Background/purpose: We evaluated the difficulty score of laparoscopic cholecystectomy (LC) for acute cholecystitis (AC) proposed in the Tokyo guidelines 2018 (TG18) and analyzed the most appropriate scoring method.
Methods: We reviewed 127 patients who underwent LC for AC from January 2018 to March 2022. According to TG18, surgical difficulty was scored for 5 categories consisting of 25 intraoperative findings. The median, highest, and mean score of the five categories were analyzed for their association with surgical outcomes.
Results: The difficulty score distribution (0 /1 /2 /3 /4 /5 /6) was as follows: median (8/ 34/ 43/ 30/ 12/ 0/ 0), highest (1/ 1/ 32/ 42/ 36/ 15/ 0) and mean (19/ 49/ 49/ 10/ 0/ 0/ 0). In all three scoring methods, higher difficulty scores were significantly correlated with longer operative time, more blood loss, and higher occurrence of subtotal cholecystectomy in trend tests. The areas under the curve (AUCs) for prediction of prolonged operative time minutes and increased blood loss were similar in all three scoring methods. For conversion to subtotal cholecystectomy, the AUC was significantly better for the highest than median and mean score (p = 0.015 and p = 0.002, respectively).
Conclusions: The difficulty score in TG18 appropriately reflects the surgical difficulty of LC for AC. The median, highest, and mean cores of the five categories are all available, and the highest scores are simple and versatile.抄録：英語フィールド
Author：Egawa N, Miyoshi A, Manabe T, Sadashima E, Koga H, Sato H, Ikeda O, Tanaka T, Kitahara K, Noshiro HTitle：Clinical evaluation of a surgical difficulty score for laparoscopic cholecystectomy for acute cholecystitis proposed in the Tokyo Guidelines 2018Announcement information:J Hepatobiliary Pancreat Sci Vol: 30 Issue: 5 Page: 625-632Keyword：Tokyo Guidelines 2018; acute cholecystitis; laparoscopic cholecystectomy; subtotal cholecystectomy; surgical difficulty scoreAn abstract：Background/purpose: We evaluated the difficulty score of laparoscopic cholecystectomy (LC) for acute cholecystitis (AC) proposed in the Tokyo guidelines 2018 (TG18) and analyzed the most appropriate scoring method.
Methods: We reviewed 127 patients who underwent LC for AC from January 2018 to March 2022. According to TG18, surgical difficulty was scored for 5 categories consisting of 25 intraoperative findings. The median, highest, and mean score of the five categories were analyzed for their association with surgical outcomes.
Results: The difficulty score distribution (0 /1 /2 /3 /4 /5 /6) was as follows: median (8/ 34/ 43/ 30/ 12/ 0/ 0), highest (1/ 1/ 32/ 42/ 36/ 15/ 0) and mean (19/ 49/ 49/ 10/ 0/ 0/ 0). In all three scoring methods, higher difficulty scores were significantly correlated with longer operative time, more blood loss, and higher occurrence of subtotal cholecystectomy in trend tests. The areas under the curve (AUCs) for prediction of prolonged operative time minutes and increased blood loss were similar in all three scoring methods. For conversion to subtotal cholecystectomy, the AUC was significantly better for the highest than median and mean score (p = 0.015 and p = 0.002, respectively).
Conclusions: The difficulty score in TG18 appropriately reflects the surgical difficulty of LC for AC. The median, highest, and mean cores of the five categories are all available, and the highest scores are simple and versatile.