{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T20:26:30Z","timestamp":1747859190987,"version":"3.40.5"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,2,13]],"date-time":"2020-02-13T00:00:00Z","timestamp":1581552000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Drip infusion cholangiography with computed tomography (DIC\u2010CT) is a major preoperative modality used for patients undergoing laparoscopic cholecystectomy (LC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study included 218 patients for whom preoperative DIC\u2010CT images were obtained prior to undergoing LC. The association between gallbladder (GB) opacification in DIC\u2010CT and the operative time was assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The GB opacification on the DIC\u2010CT images was classified as follows: Grade 0, homogeneous opacification; Grade 1, heterogeneous opacification; Grade 2, only cystic duct can be identified; and Grade 3, no opacification. Images obtained for the 218 patients showed 41 (18.8%) with Grade 0, 91 (41.7%) with Grade 1, 54 (24.8%) with Grade 2, and 32 (14.7%) with Grade 3. The operative time and intraoperative blood loss were significantly longer and larger, respectively, in cases classified as Grade 2 or 3 (GB negative) compared with cases classified as Grade 0 or 1 (GB positive). We created an LC difficulty score based on the following variables that were significant independent predictors of increased operative time: GB negativity in DIC\u2010CT (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.002, 2 points), GB wall thickness (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.002, 2 points), body mass index (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.015, 1 point), preoperative alkaline phosphatase value (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.018, 1 point), and preoperative C\u2010reactive protein value (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.04, 1 point). The LC difficulty score (Grade A, score 0\u20102; Grade B, score 3\u20105; and Grade C, score 6\u20107) was significantly associated with a prolonged operative time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Drip infusion cholangiography with computed tomography is useful for predicting the surgical difficulty of LC.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhbp.718","type":"journal-article","created":{"date-parts":[[2020,1,23]],"date-time":"2020-01-23T10:44:45Z","timestamp":1579776285000},"page":"315-323","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Usefulness of preoperative drip infusion cholangiography with computed tomography for predicting surgical difficulty during laparoscopic cholecystectomy"],"prefix":"10.1002","volume":"27","author":[{"given":"Akiko","family":"Nakazawa","sequence":"first","affiliation":[{"name":"Hepato\u2010Biliary\u2010Pancreatic Surgery Division and Artificial Organ and Transplantation Division Department of Surgery Graduate School of Medicine The University of Tokyo Tokyo Japan"},{"name":"Department of Hepato\u2010biliary\u2010pancreatic Surgery Saitama Medical Center Saitama Medical University Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1603-5147","authenticated-orcid":false,"given":"Nobuhisa","family":"Akamatsu","sequence":"additional","affiliation":[{"name":"Hepato\u2010Biliary\u2010Pancreatic Surgery Division and Artificial Organ and Transplantation Division Department of Surgery Graduate School of Medicine The University of Tokyo Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5201-4477","authenticated-orcid":false,"given":"Yoichi","family":"Miyata","sequence":"additional","affiliation":[{"name":"Hepato\u2010Biliary\u2010Pancreatic Surgery Division and Artificial Organ and Transplantation Division Department of Surgery Graduate School of Medicine The University of Tokyo Tokyo Japan"},{"name":"Department of Hepato\u2010biliary\u2010pancreatic Surgery Saitama Medical Center Saitama Medical University Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiko","family":"Komagome","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010biliary\u2010pancreatic Surgery Saitama Medical Center Saitama Medical University Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akira","family":"Maki","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010biliary\u2010pancreatic Surgery Saitama Medical Center Saitama Medical University Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1929-8479","authenticated-orcid":false,"given":"Junichi","family":"Arita","sequence":"additional","affiliation":[{"name":"Hepato\u2010Biliary\u2010Pancreatic 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