{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T10:11:27Z","timestamp":1791972687274,"version":"4.3.4"},"reference-count":47,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2017,10,23]],"date-time":"2017-10-23T00:00:00Z","timestamp":1508716800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Bile duct injury (\n                    <jats:styled-content style=\"fixed-case\">BDI<\/jats:styled-content>\n                    ) during laparoscopic cholecystectomy remains a serious iatrogenic surgical complication.\n                    <jats:styled-content style=\"fixed-case\">BDI<\/jats:styled-content>\n                    most often occurs as a result of misidentification of the anatomy; however, clinical evidence on its precise mechanism and surgeons\u2019 perceptions is scarce. Surgeons from Japan, Korea, Taiwan, and the USA, etc. (\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u00a0614) participated in a questionnaire regarding their\n                    <jats:styled-content style=\"fixed-case\">BDI<\/jats:styled-content>\n                    experience and near\u2010misses; and perceptions on landmarks, intraoperative findings, and surgical techniques. Respondents voted for a Delphi process and graded each item on a five\u2010point scale. The consensus was built when \u226580% of overall responses were 4 or 5. Response rates for the first\u2010 and second\u2010round Delphi were 60.6% and 74.9%, respectively. Misidentification of local anatomy accounted for 76.2% of\n                    <jats:styled-content style=\"fixed-case\">BDI<\/jats:styled-content>\n                    . Final consensus was reached on: (1) Effective retraction of the gallbladder, (2) Always obtaining critical view of safety, and (3) Avoiding excessive use of electrocautery\/clipping as vital procedures; and (4) Calot's triangle area and (5) Critical view of safety as important landmarks. For (6) Impacted gallstone and (7) Severe fibrosis\/scarring in Calot's triangle, bail\u2010out procedures may be indicated. A consensus was reached among expert surgeons on relevant landmarks and intraoperative findings and appropriate surgical techniques to avoid\n                    <jats:styled-content style=\"fixed-case\">BDI<\/jats:styled-content>\n                    .\n                  <\/jats:p>","DOI":"10.1002\/jhbp.503","type":"journal-article","created":{"date-parts":[[2017,9,8]],"date-time":"2017-09-08T06:57:15Z","timestamp":1504853835000},"page":"591-602","source":"Crossref","is-referenced-by-count":107,"title":["Delphi consensus on bile duct injuries during laparoscopic cholecystectomy: an evolutionary cul\u2010de\u2010sac or the birth pangs of a new technical framework?"],"prefix":"10.1002","volume":"24","author":[{"given":"Yukio","family":"Iwashita","sequence":"first","affiliation":[{"name":"Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita 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