Annals of hepato-biliary-pancreatic surgery最新文献

{"title":"Internal and external validation of indocyanine green plasma disappearance rate to discard liver grafts before procurement.","authors":"Sergio Cortese, Katherine Plua, Alejandro J Perez-Alonso, María Savoie Hontoria, David Pacheco, Natalia Zambudio Carroll, Manuel Ángel Barrera Gómez, José María Pérez Peña, Álvaro G Morales Taboada, María Fernández Martínez, Sergio Hernández Kakauridze, Ana María Matilla, José Ángel López Baena, José Manuel Asencio","doi":"10.14701/ahbps.24-086","DOIUrl":"10.14701/ahbps.24-086","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>Thirty percent of liver grafts in donors after brain death (DBD) in Spain are rejected by procurement surgeons owing to marginal graft quality. Poor donor indocyanine green (ICG) clearance has been associated with graft discard and malfunction. This study aimed to internally and externally validate the predictive value of ICG-plasma disappearance rate (ICG-PDR) to reject grafts before donation and set a cut-off to avoid missing any potential effective donors.</p><p><strong>Methods: </strong>Between March 2017 and August 2023, ICG clearance test was performed immediately before procurement in 71 DBD. The surgeon was blinded to test results. Univariate and multivariate analyses were performed to detect independent predictors of graft discard. Discrimination and calibration of predictors were assessed and a cut-off with 100% specificity was set. External validation was performed on 17 donors evaluated by three other transplantation teams.</p><p><strong>Results: </strong>In the training cohort, 30 of 71 grafts were discarded for transplantation. ICG-PDR was the only donor variable independently associated with graft discard. The area under receiver operating characteristic curve for ICG-PDR was 0.875 (95% confidence interval: 0.768-0.947) and good calibration was observed. Below a PDR of 13.5%/min, no graft was accepted for transplantation. These results were successfully validated using the external cohort of donors.</p><p><strong>Conclusions: </strong>ICG clearance test performed in DBD was internally and externally validated to predict liver graft discard. It could be used as a screening tool before donation to avoid unnecessary costs of travel and human resources.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"458-465"},"PeriodicalIF":1.1,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11599826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A review of ergonomic positions to improve musculoskeletal distress in hepatobiliary pancreatic surgeons according to open, laparoscopic, and robotic surgeries.","authors":"Young Jae Cho, Jin-Young Jang","doi":"10.14701/ahbps.24-127","DOIUrl":"10.14701/ahbps.24-127","url":null,"abstract":"<p><p>Advances in surgical ergonomics are essential for the performance, health, and career longevity of surgeons. Many surgeons experience work-related musculoskeletal disorders (WMSDs) resulting from various surgical modalities, including open, laparoscopic, and robotic surgeries. To prevent WMSDs, individual differences may exist depending on the surgical method; however, the key is to maintain a neutral posture, and avoid static postures. This review aims to summarize the concepts of ergonomics and WMSDs; identify the ergonomic challenges of open, laparoscopic, and robotic surgeries; and discuss ergonomic recommendations to improve them.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"433-439"},"PeriodicalIF":1.1,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11599811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic management of huge hepatic angiomyolipoma: A case report and literature review.","authors":"Andrew Park, Kush Savsani, Anjelica Alfonso, Ester Jo, Bryce Hatfield, Daisuke Imai, Aamir Khan, Amit Sharma, Irfan Saeed, Vinay Kumaran, Adrian Cotterell, David Bruno, Yuzuru Sambommatsu, Seung Lee","doi":"10.14701/ahbps.24-033","DOIUrl":"10.14701/ahbps.24-033","url":null,"abstract":"<p><p>Hepatic angiomyolipoma (HAML) is a rare, benign mesenchymal liver tumor encountered in Asia, primarily in females, and can be found within the right hepatic lobe, but also in other areas of the liver. Immunohistochemically, HAMLs are characteristically positive for human melanoma black-45 antigen (HMB-45) and can histochemically vary in the composition of angiomatous, lipomatous, and myomatous tissue, together with the presence of epithelioid cells. In this case report, we discuss a previously healthy patient presenting with bloating and previously documented concern of liver lesions, found to have HAML confirmed by surgical pathology. Surgery was decided, as HAMLs greater than 10 cm are at risk of rupture. This is one of the first documented cases of HAML resected through robot-assisted bisegmentectomy and cholecystectomy, and therefore, intraoperative images have been included to assist in the planning of future robotic cases.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"527-534"},"PeriodicalIF":1.1,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11599823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Segments 4, 7, and 8 liver resection: A case report.","authors":"Pilar Leal-Leyte, Carlos Ulises Camarillo-Sánchez, Daniel Zamora-Valdés","doi":"10.14701/ahbps.24-092","DOIUrl":"10.14701/ahbps.24-092","url":null,"abstract":"<p><p>Right superior resection (segments 7 and 8) is an uncommon resection for liver malignancies, with most of the literature limited to case reports and small series. Resection of segments 4, 7, and 8 has been reported in only a few cases. When the right hepatic vein is resected, venous reconstruction or identification of one or more right inferior hepatic veins is considered mandatory, to maintain segmentary function of segments 5 and 6. We present a case of liver resection of segments 4, 7, and 8 including the right and middle hepatic veins for symptomatic benign liver disease with no right hepatic vein reconstruction, nor a prominent right inferior hepatic vein(s). After the resection, there was no change in liver function tests, and the patient made an unremarkable recovery. Three months after the operation, partial atrophy of segments 5 and 6 with hypertrophy of the left lateral section was observed, while two and one half years after resection, the patient is asymptomatic. When right hepatic vein reconstruction would add unnecessary operative time, and there is low likelihood of the need for repeated resection, particularly when the hepatic vein is difficult to dissect, this approach can be safe and useful, while providing an adequate postoperative liver mass in the short-term to recover uneventfully from major liver resection.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"522-526"},"PeriodicalIF":1.1,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11599812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141763007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liver transplantation for organ failure following multiple locoregional treatments for breast cancer metastasis.","authors":"Giammauro Berardi, Valerio Giannelli, Marco Colasanti, Roberto Cianni, Roberto Meniconi, Nicola Guglielmo, Stefano Ferretti, Ludovica Di Cesare, Adriano Pellicelli, Guido Ventroni, Enrico Cortesi, Giuseppe Maria Ettorre","doi":"10.14701/ahbps.24-101","DOIUrl":"10.14701/ahbps.24-101","url":null,"abstract":"<p><p>Patients with nonresectable breast cancer liver metastasis (BCLM) face a dismal prognosis. Despite liver transplantation (LT) for metastatic liver tumors having recently shown good results, BCLM represents an absolute contraindication. This study aimed to investigate the potential for long-term survival after LT for BCLMs in a patient experiencing end-stage liver disease, following multiple oncologic treatments. In July 2019, we performed a deceased donor LT on a 41-year-old female with BCLM controlled with human epidermal growth factor receptor 2 targeted therapy, who developed liver failure following multiple locoregional liver-directed treatments. The primary tumor was treated with surgical resection and adjuvant chemoradiation in 2000. The procedure was performed under a protocol approved by the local ethical committee, and by the Italian National Transplant Center. A 12-month treatment with trastuzumab was performed immediately after LT. Immunosuppression following transplantation was undertaken without steroids, and with everolimus. The patient completed 12 months of follow-up without recurrence. Trastuzumab was then withdrawn. Fifteen months after LT, a liver recurrence occurred that was treated with chemotherapy. In October 2021, she developed 2 brain lesions that were treated with stereotactic radiation. The patient is still alive, with a positron emission tomography/computed tomography performed in January 2024 showing no disease. LT for this patient with BCLM of extreme selectivity showed a good clinical outcome. Perioperative systemic treatment and tumor control are necessary. A specific protocol should be discussed within a multidisciplinary team, and with local and national authorities. Even if tumor recurrence occurs, multimodal therapy can control the disease.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"516-521"},"PeriodicalIF":1.1,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11599815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of myosteatosis on postoperative outcomes and survival of patients undergoing pancreatoduodenectomy for suspected/confirmed malignancy.","authors":"Paul Jenkins, Andrew MacCormick, Adam Streeter, Mark Puckett, Gemma Miles, Somaiah Aroori","doi":"10.14701/ahbps.23-115","DOIUrl":"10.14701/ahbps.23-115","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>While the effects of myosteatosis are emerging, the evidence for its use as a predictor of outcomes in patients undergoing pancreatoduodenectomy (PD) still needs to be established. The study aims to evaluate the effect of myosteatosis on the shortand long-term outcomes of PD.</p><p><strong>Methods: </strong>We analyzed the effect of myosteatosis on the short- and long-term outcomes of patients who underwent PD between July 2006 and May 2013. Myosteatosis was measured retrospectively from preoperative computed tomography (CT) at the L3 vertebra level, and dichotomized as a binary exposure variable as < 38.5 Hounsfield unit (HU) for males, and < 36.1 HU for females.</p><p><strong>Results: </strong>A total of 214 patient (median age 62 years, range: 41-80 years) CTs were analyzed for myosteatosis. Overall, 120/214 (56.1%) patients were classed as having myosteatosis. Both groups had similar comorbidity profiles. The presence of myosteatosis was not shown to increase the rate of any short- or long-term complication. However, pancreatic leak (29.8% vs. 13.3%; <i>p</i> = 0.006) and postoperative bleeding (13.8% vs. 5.0%; <i>p</i> = 0.034) were higher in the non-myosteatosis group. The median intensive care (2 days) and hospital stay (12 days) were the same in both groups. The 30-day mortality (myosteatosis: 3.3% vs. non-myosteatosis: 3.2%; <i>p</i> = 0.95), and 5-year overall survival (myosteatosis: 26.7% vs. non-myosteatosis: 31.9%; <i>p</i> = 0.5), were similar in both groups.</p><p><strong>Conclusions: </strong>We have found no evidence supporting myosteatosis affecting either the short-term or long-term outcomes of patients undergoing PD for suspected/confirmed malignant tumors.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"494-499"},"PeriodicalIF":1.1,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11599814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142094258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative outcomes of robot-assisted pancreatoduodenectomy (PD) and totally laparoscopic PD after overcoming learning curves with comparison of oncologic outcomes between open PD and minimally invasive PD.","authors":"Jae Seung Kang, Mirang Lee, Jun Suh Lee, Youngmin Han, Hee Ju Sohn, Boram Lee, Moonhwan Kim, Wooil Kwon, Ho-Seong Han, Yoo-Seok Yoon, Jin-Young Jang","doi":"10.14701/ahbps.24-121","DOIUrl":"10.14701/ahbps.24-121","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>Minimally invasive pancreatoduodenectomy (MIPD), such as totally laparoscopic pancreatoduodenectomy (TLPD) or robot-assisted pancreatoduodenectomy (RAPD), is increasingly performed worldwide. This study aimed to compare the perioperative outcomes of TLPD and RAPD, and compare the oncologic outcomes between MIPD and open pancreatoduodenectomy (OPD) for malignant disease.</p><p><strong>Methods: </strong>This retrospective study was conducted at two hospitals that followed similar oncological surgical principles, including the extent of resection. RAPD was performed at Seoul National University Hospital, and TLPD at Seoul National University Bundang Hospital. Patient demographics, perioperative outcomes, and oncological outcomes were analyzed. Propensity score matching (PSM) analysis was performed to compare oncologic outcomes between MIPD and OPD.</p><p><strong>Results: </strong>Between 2015 and 2020, 332 RAPD and 178 TLPD were performed. The rates of Clavian-Dindo grade ≥ 3 complications (19.3% vs. 20.2%, <i>p</i> = 0.816), clinically relevant postoperative pancreatic fistula (9.9% vs. 11.8%, <i>p</i> = 0.647), and open conversions (6.6% vs. 10.5%, <i>p</i> = 0.163) were comparable between the two groups. The mean operation time (341 minutes vs. 414 minutes, <i>p</i> < 0.001) and postoperative hospital stay were shorter in the RAPD group (11 days vs. 14 days, <i>p</i> = 0.034). After PSM, the 5-year overall survival rate was comparable between MIPD and OPD for overall malignant disease (58.4% vs. 55.5%, <i>p</i> = 0.180).</p><p><strong>Conclusions: </strong>Both RAPD and TLPD are safe and feasible, and MIPD has clinical outcomes that are comparable to those of OPD. Although RAPD exhibits some advantages, its perioperative outcomes are similar to those associated with TLPD. A surgical method may be selected based on the convenience of surgical movements, medical costs, and operator experience.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"508-515"},"PeriodicalIF":1.1,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11599824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative accuracy of four guidelines to predict high-grade dysplasia or malignancy in surgically resected pancreatic intraductal papillary mucinous neoplasms: Small nuances between guidelines lead to vastly different results.","authors":"Irene C Perez, Andrew Bigelow, Vanessa M Shami, Bryan G Sauer, Andrew Y Wang, Daniel S Strand, Alexander J Podboy, Todd W Bauer, Victor M Zaydfudim, Allan Tsung, Ross C D Buerlein","doi":"10.14701/ahbps.24-049","DOIUrl":"10.14701/ahbps.24-049","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>The guidelines regarding the management of intraductal papillary mucinous neoplasms (IPMNs) all have slightly different surgical indications for high-risk lesions. We aim to retrospectively compare the accuracy of four guidelines in recommending surgery for high-risk IPMNs, and assess the accuracy of elevated CA-19-9 levels and imaging characteristics of IPMNs considered high-risk in predicting malignancy or high-grade dysplasia (HGD).</p><p><strong>Methods: </strong>The final histopathological diagnosis of surgically resected high-risk IPMNs during 2013-2020 were compared to preoperative surgical indications, as enumerated in four guidelines: the 2015 American Gastroenterological Association (AGA), 2017 International Consensus, 2018 European Study Group, and 2018 American College of Gastroenterology (ACG). Surgery was considered \"justified\" if histopathology of the surgical specimen showed HGD/malignancy, or there was postoperative symptomatic improvement.</p><p><strong>Results: </strong>Surgery was postoperatively justified in 26/65 (40.0%) cases. All IPMNs with HGD/malignancy were detected by the 2018 ACG and the combined (absolute and relative criteria) 2018 European guidelines. The combined (\"high-risk stigmata\" and \"worrisome features\") 2017 International guideline missed 1/19 (5.3%) IPMNs with HGD/malignancy. The 2015 AGA guideline missed the most cases (11/19, 57.9%) of IPMNs with HGD/malignancy. We found the features most-associated with HGD/malignancy were pancreatic ductal dilation, and elevated CA-19-9 levels.</p><p><strong>Conclusions: </strong>Following the 2015 AGA guideline results in the highest rate of missed HGD/malignancy, but the lowest rate of operating on IPMNs without these features; meanwhile, the 2018 ACG and the combined (absolute and relative criteria) 2018 European guidelines result in more operations for IPMNs without HGD/malignancy, but the lowest rates of missed HGD/malignancy in IPMNs.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"483-493"},"PeriodicalIF":1.1,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11599813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of post-hepatectomy biliary leaks on long-term survival in different liver tumors: A single institute experience.","authors":"Devesh Sanjeev Ballal, Shraddha Patkar, Aditya Kunte, Sridhar Sundaram, Nitin Shetty, Kunal Gala, Suyash Kulkarni, Mahesh Goel","doi":"10.14701/ahbps.24-078","DOIUrl":"10.14701/ahbps.24-078","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>A postoperative biliary leak is one of the most morbid complications occurring after a liver resection, the long-term impact of which remains unknown.</p><p><strong>Methods: </strong>Retrospective analysis of consecutive liver resections performed from 1 January 2011 to 31 December 2021. Primary endpoint of disease-free survival (DFS) was compared between patients with and without a bile leak, stratifying for tumor type. Survival curves were plotted using Kaplan-Meier estimates, and differences between them were analyzed using the log-rank test.</p><p><strong>Results: </strong>In toto, 862 patients were analyzed, and included 306 (35.5%) hepatocellular carcinomas, 212 (24.6%) metastatic colorectal cancers, and 111 (12.9%) cholangiocarcinomas (69 intrahepatic cholangiocarcinomas, 42 hilar cholangiocarcinomas). Occurrence of a bile leak was associated with significantly poorer DFS only in patients with cholangiocarcinoma (median DFS 9.9 months vs. 24.9 months, <i>p</i> = 0.013), and further analysis was restricted to this cohort. A Cox regression performed for factors associated with DFS detriment in patients with cholangiocarcinoma showed that apart from node positivity (hazard ratio [HR]: 2.482, <i>p</i> = 0.033) and margin positivity (HR: 2.65, <i>p</i> = 0.021), development of a bile leak was independently associated with worsening DFS on both univariate and multiple regression analyses (HR: 1.896, <i>p</i> = 0.033).</p><p><strong>Conclusions: </strong>Post-hepatectomy biliary leaks are associated with significantly poorer DFS only in patients with cholangiocarcinoma, but not in patients with hepatocellular carcinoma or metastatic colorectal cancer. Methods to mitigate this survival detriment need to be explored.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"451-457"},"PeriodicalIF":1.1,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11599820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep learning-based surgical phase recognition in laparoscopic cholecystectomy.","authors":"Hye Yeon Yang, Seung Soo Hong, Jihun Yoon, Bokyung Park, Youngno Yoon, Dai Hoon Han, Gi Hong Choi, Min-Kook Choi, Sung Hyun Kim","doi":"10.14701/ahbps.24-091","DOIUrl":"10.14701/ahbps.24-091","url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>Artificial intelligence (AI) technology has been used to assess surgery quality, educate, and evaluate surgical performance using video recordings in the minimally invasive surgery era. Much attention has been paid to automating surgical workflow analysis from surgical videos for an effective evaluation to achieve the assessment and evaluation. This study aimed to design a deep learning model to automatically identify surgical phases using laparoscopic cholecystectomy videos and automatically assess the accuracy of recognizing surgical phases.</p><p><strong>Methods: </strong>One hundred and twenty cholecystectomy videos from a public dataset (Cholec80) and 40 laparoscopic cholecystectomy videos recorded between July 2022 and December 2022 at a single institution were collected. These datasets were split into training and testing datasets for the AI model at a 2:1 ratio. Test scenarios were constructed according to structural characteristics of the trained model. No pre- or post-processing of input data or inference output was performed to accurately analyze the effect of the label on model training.</p><p><strong>Results: </strong>A total of 98,234 frames were extracted from 40 cases as test data. The overall accuracy of the model was 91.2%. The most accurate phase was Calot's triangle dissection (F1 score: 0.9421), whereas the least accurate phase was clipping and cutting (F1 score: 0.7761).</p><p><strong>Conclusions: </strong>Our AI model identified phases of laparoscopic cholecystectomy with a high accuracy.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":" ","pages":"466-473"},"PeriodicalIF":1.1,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11599821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141790161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}