{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T04:08:57Z","timestamp":1768450137429,"version":"3.49.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2021,2,15]],"date-time":"2021-02-15T00:00:00Z","timestamp":1613347200000},"content-version":"vor","delay-in-days":161,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,9,7]],"date-time":"2020-09-07T00:00:00Z","timestamp":1599436800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,9,7]],"date-time":"2020-09-07T00:00:00Z","timestamp":1599436800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,12,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Severe inflammation with necrosis and fibrosis of the gallbladder in acute cholecystitis increases operative difficulty during laparoscopic cholecystectomy. This study aimed to assess the use of preoperative MRI in predicting pathological changes of the gallbladder associated with surgical difficulty.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients who underwent both preoperative MRI and early cholecystectomy for acute cholecystitis between 2012 and 2018 were identified retrospectively. On the basis of the layered pattern of the gallbladder wall on MRI, patients were classified into three groups: high signal intensity (HSI), intermediate signal intensity (ISI), and low signal intensity (LSI). The endpoint was the presence of pathological changes of the gallbladder associated with surgical difficulty, such as necrosis, abscess formation and fibrosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 229 eligible patients, pathological changes associated with surgical difficulty were found in 17 (27 per cent) of 62 patients in the HSI group, 84 (85 per cent) of 99 patients in the ISI group, and 66 (97 per cent) of 68 patients in the LSI group (P &amp;lt; 0\u00b7001). For detecting these changes, intermediate to low signal intensity of the gallbladder wall had a sensitivity of 90 (95 per cent c.i. 84 to 94) per cent, specificity of 73 (60 to 83) per cent and accuracy of 85 (80 to 90) per cent.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Preoperative MRI predicted pathological changes associated with surgical difficulty during laparoscopic cholecystectomy for acute cholecystitis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs5.50344","type":"journal-article","created":{"date-parts":[[2020,9,17]],"date-time":"2020-09-17T07:21:23Z","timestamp":1600327283000},"page":"1137-1145","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Preoperative MRI for predicting pathological changes associated with surgical difficulty during laparoscopic cholecystectomy for acute cholecystitis"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7691-0073","authenticated-orcid":false,"given":"K","family":"Omiya","sequence":"first","affiliation":[{"name":"Department of General Surgery, Toyohashi Municipal Hospital , 50 Hakken-Nishi, Aotake-cho, Toyohashi City, Aichi Prefecture, 440-8570, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K","family":"Hiramatsu","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Toyohashi Municipal Hospital , 50 Hakken-Nishi, Aotake-cho, Toyohashi City, Aichi Prefecture, 440-8570, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Toyohashi Municipal Hospital , 50 Hakken-Nishi, Aotake-cho, Toyohashi City, Aichi Prefecture, 440-8570, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y","family":"Shibata","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Toyohashi Municipal Hospital , 50 Hakken-Nishi, Aotake-cho, Toyohashi City, Aichi Prefecture, 440-8570, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Yoshihara","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Toyohashi Municipal Hospital , 50 Hakken-Nishi, Aotake-cho, Toyohashi City, Aichi Prefecture, 440-8570, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T","family":"Aoba","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Toyohashi Municipal Hospital , 50 Hakken-Nishi, Aotake-cho, Toyohashi City, Aichi Prefecture, 440-8570, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Arimoto","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Toyohashi Municipal Hospital , 50 Hakken-Nishi, Aotake-cho, Toyohashi City, Aichi Prefecture, 440-8570, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Toyohashi Municipal Hospital , 50 Hakken-Nishi, Aotake-cho, Toyohashi City, Aichi Prefecture, 440-8570, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,9,7]]},"reference":[{"key":"2023020208202627500_bjs550344-bib-0001","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1002\/jhbp.517","article-title":"Tokyo Guidelines 2018: surgical management of acute cholecystitis: safe steps in laparoscopic cholecystectomy for acute cholecystitis (with videos)","volume":"25","author":"Wakabayashi","year":"2018","journal-title":"J Hepatobiliary Pancreat Sci"},{"key":"2023020208202627500_bjs550344-bib-0002","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1007\/s00268-015-3365-1","article-title":"Severity of acute cholecystitis and risk of iatrogenic bile duct injury during cholecystectomy, a population-based case\u2013control study","volume":"40","author":"Tornqvist","year":"2016","journal-title":"World J Surg"},{"key":"2023020208202627500_bjs550344-bib-0003","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1002\/jhbp.375","article-title":"What are the appropriate indicators of surgical difficulty during laparoscopic cholecystectomy? 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