{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T17:31:07Z","timestamp":1782495067156,"version":"3.54.5"},"reference-count":39,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2021,2,24]],"date-time":"2021-02-24T00:00:00Z","timestamp":1614124800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Previous studies have shown that signal intensity variations in the gallbladder wall on magnetic resonance imaging (MRI) are associated with necrosis and fibrosis in the gallbladder of acute cholecystitis (AC). However, the association between MRI findings and operative outcomes remains unclear. We retrospectively identified 321 patients who underwent preoperative magnetic resonance cholangiopancreatography (MRCP) and early laparoscopic cholecystectomy (LC) for AC. Based on the gallbladder wall signal intensity on MRI, these patients were divided into high signal intensity (HSI), intermediate signal intensity (ISI), and low signal intensity (LSI) groups. Comparisons of bailout procedure rates (open conversion and laparoscopic subtotal cholecystectomy) and operating times were performed. The recorded bailout procedure rates were 6.8% (7\/103 cases), 26.7% (31\/116 cases), and 40.2% (41\/102 cases), and the median operating times were 95, 110, and 138 minutes in the HSI, ISI, and LSI groups, respectively (both p &lt; 0.001). During the multivariate analysis, the LSI of the gallbladder wall was an independent predictor of both the bailout procedure (odds ratio [OR] 5.30; 95% CI 2.11\u201313.30; p &lt; 0.001) and prolonged surgery (\u2265144 min) (OR 6.10, 95% CI 2.74\u201313.60, p &lt; 0.001). Preoperative MRCP\/MRI assessment could be a novel method for predicting surgical difficulty during LC for AC.<\/jats:p>","DOI":"10.3390\/diagnostics11030383","type":"journal-article","created":{"date-parts":[[2021,2,24]],"date-time":"2021-02-24T20:53:21Z","timestamp":1614200001000},"page":"383","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Preoperative Magnetic Resonance Cholangiopancreatography for Detecting Difficult Laparoscopic Cholecystectomy in Acute Cholecystitis"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7691-0073","authenticated-orcid":false,"given":"Kojiro","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":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiro","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":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihisa","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":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahide","family":"Fukaya","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Toyohashi Municipal Hospital, 50 Hakken-Nishi, Aotake-Cho, Toyohashi City, Aichi Prefecture 440-8570, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Fujii","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Toyohashi Municipal Hospital, 50 Hakken-Nishi, Aotake-Cho, Toyohashi City, Aichi Prefecture 440-8570, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taro","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":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsuki","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":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Toyohashi Municipal Hospital, 50 Hakken-Nishi, Aotake-Cho, Toyohashi City, Aichi Prefecture 440-8570, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takehito","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":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,2,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1002\/jhbp.516","article-title":"Tokyo Guidelines 2018: Flowchart for the manage-ment of acute cholecystitis","volume":"2","author":"Okamoto","year":"2018","journal-title":"J. Hepato Biliary Pancreatic Sci."},{"key":"ref_2","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. Hepato Biliary Pancreatic Sci."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1639","DOI":"10.1001\/jama.289.13.1639","article-title":"Intraoperative Cholangiography and Risk of Common Bile Duct Injury during Cholecystectomy","volume":"289","author":"Flum","year":"2003","journal-title":"JAMA"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1097\/00019509-199602000-00014","article-title":"A rare right hepatic duct anatomical variant discovered after laparoscopic bile duct transection","volume":"2","author":"Seibert","year":"1996","journal-title":"Surg. Laparosc. Endosc."},{"key":"ref_5","first-page":"571","article-title":"Bile duct injury during laparoscopic cholecystecto-my: A prospective nationwide series","volume":"2","author":"Adamsen","year":"1997","journal-title":"J. Am. Coll. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1067\/msy.2002.127681","article-title":"New strategies to prevent laparoscopic bile duct injury\u2014Surgeons can learn from pilots","volume":"132","author":"Hugh","year":"2002","journal-title":"Surgery"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1002\/bjs.4831","article-title":"Role of laparoscopic cholecystectomy in the early management of acute gallbladder disease","volume":"92","author":"Peng","year":"2005","journal-title":"BJS"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1007\/s00423-008-0447-7","article-title":"Is routine MR cholangiopancreatography (MRCP) justified prior to cholecystectomy?","volume":"394","author":"Nebiker","year":"2008","journal-title":"Langenbeck\u2019s Arch. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1007\/s00534-011-0456-8","article-title":"Preoperative MRCP to detect choledocholithiasis in acute calculous cholecystitis","volume":"19","author":"Wong","year":"2012","journal-title":"J. Hepato Biliary Pancreatic Sci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1002\/jhbp.252","article-title":"Preoperative detection and handling of aberrant right posterior sectoral hepatic duct during laparoscopic cholecystectomy","volume":"22","author":"Kurata","year":"2015","journal-title":"J. Hepato Biliary Pancreatic Sci."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1007\/s00330-004-2539-2","article-title":"Gallbladder wall thickening: MR imaging and pathologic correla-tion with emphasis on layered pattern","volume":"2","author":"Jung","year":"2005","journal-title":"Eur. Radiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1002\/bjs5.50344","article-title":"Preoperative MRI for predicting pathological changes associated with surgical difficulty during laparoscopic cholecystectomy for acute cholecystitis","volume":"4","author":"Omiya","year":"2020","journal-title":"BJS Open"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1007\/s00534-006-1159-4","article-title":"Diagnostic criteria and severity assessment of acute cholecystitis: Tokyo Guidelines","volume":"14","author":"Hirota","year":"2007","journal-title":"J. Hepato Biliary Pancreatic Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1007\/s00534-012-0568-9","article-title":"TG13 diagnostic criteria and severity grading of acute cholecystitis (with videos)","volume":"20","author":"Yokoe","year":"2013","journal-title":"J. Hepato Biliary Pancreatic Sci."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1002\/jhbp.515","article-title":"Tokyo Guidelines 2018: Diagnostic criteria and severity grading of acute cholecystitis (with videos)","volume":"25","author":"Yokoe","year":"2018","journal-title":"J. Hepato Biliary Pancreatic Sci."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1007\/s00534-012-0567-x","article-title":"TG13 surgical management of acute cholecystitis","volume":"2","author":"Yamashita","year":"2013","journal-title":"J. Hepato Biliary Pancreatic Sci."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2654","DOI":"10.1007\/s00268-012-1709-7","article-title":"Comparison of Laparoscopic Cholecystectomy for Acute Cholecystitis within and Beyond 72 h of Symptom Onset During Emergency Admissions","volume":"36","author":"Zhu","year":"2012","journal-title":"World J. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13017-016-0111-4","article-title":"Laparoscopic cholecystectomy for acute calculous cholecystitis: A retrospective study assessing risk factors for conversion and complications","volume":"11","author":"Terho","year":"2016","journal-title":"World J. Emerg. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1097\/SLE.0b013e31805d093b","article-title":"A 14-year analysis of laparoscopic cholecystectomy: Conversion\u2014When and why?","volume":"2","author":"Shamiyeh","year":"2007","journal-title":"Surg. Laparosc. Endosc. Percutan. Tech."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/S0002-9610(00)00248-8","article-title":"Preoperative evaluation to predict technical difficulties of laparo-scopic cholecystectomy on the basis of histological inflammation findings on resected gallbladder","volume":"2","author":"Sakuramoto","year":"2000","journal-title":"Am. J. Surg."},{"key":"ref_21","first-page":"414","article-title":"Preoperative Risk Factors for Conversion of Laparoscopic Cholecystectomy to Open Surgery\u2014A Systematic Review and Meta-Analysis of Observational Studies","volume":"2","author":"Burcharth","year":"2016","journal-title":"Dig. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1188","DOI":"10.1177\/000313480707301123","article-title":"Timing of laparoscopic cholecystectomy for acute cholecystitis: Evidence to sup-port a proposal for an early interval surgery","volume":"2","author":"Low","year":"2007","journal-title":"Am. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.5833\/jjgs.40.1449","article-title":"Preoperative evaluation of difficulty on laparo-scopic cholecystectomy (in Japanese)","volume":"40","author":"Hiromatsu","year":"2007","journal-title":"Jpn. Gastroenterol. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2561","DOI":"10.1007\/s00464-013-2787-9","article-title":"The value of percutaneous ultrasound in predicting conversion from laparoscopic to open cholecystectomy due to acute cholecystitis","volume":"27","author":"Skoczylas","year":"2013","journal-title":"Surg. Endosc."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1002\/jcu.20001","article-title":"Evaluation of preoperative sonography in acute cholecystitis to predict technical difficulties during laparoscopic cholecystectomy","volume":"32","author":"Cho","year":"2004","journal-title":"J. Clin. Ultrasound"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1001\/archsurg.2010.332","article-title":"Hepatobiliary Scan for Assessing Disease Severity in Patients with Cholelithiasis","volume":"146","author":"Cho","year":"2011","journal-title":"Arch. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12876-015-0365-4","article-title":"Does the Tokyo guidelines predict the extent of gallbladder inflammation in patients with acute cholecystitis? A single center retrospective analysis","volume":"15","author":"Ambe","year":"2015","journal-title":"BMC Gastroenterol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"275","DOI":"10.2214\/ajr.178.2.1780275","article-title":"CT Findings in Acute Gangrenous Cholecystitis","volume":"178","author":"Bennett","year":"2002","journal-title":"Am. J. Roentgenol."},{"key":"ref_29","first-page":"419","article-title":"Preoperative Risk Factors for Conversion of Laparoscopic Cholecystectomy to Open Cholecystectomy and the Usefulness of the 2013 Tokyo Guidelines","volume":"71","author":"Utsumi","year":"2017","journal-title":"Acta Med. Okayama"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1111\/hpb.12100","article-title":"Risk factors for a prolonged operative time in a sin-gle-incision laparoscopic cholecystectomy","volume":"16","author":"Sato","year":"2014","journal-title":"HPB"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1089\/lap.1998.8.137","article-title":"Laparoscopic Cholecystectomy for Acute Cholecystitis Performed by Residents in Surgery: A Risk Factor for Conversion to Open Laparotomy?","volume":"8","author":"Bickel","year":"1998","journal-title":"J. Laparoendosc. Adv. Surg. Tech."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1097\/00000658-199804000-00001","article-title":"Prospective randomized study of early versus delayed laparoscopic cholecystec-tomy for acute cholecystitis","volume":"2","author":"Lo","year":"1998","journal-title":"Ann. Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1046\/j.1365-2168.1998.00708.x","article-title":"Randomized trial of early versus delayed laparoscopic cholecystectomy for acute cholecystitis","volume":"85","author":"Lai","year":"1998","journal-title":"BJS"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1007\/s00464-003-9230-6","article-title":"Early versus delayed laparoscopic cholecystecto-my for acute cholecystitis: A prospective randomized trial","volume":"2","author":"Kolla","year":"2004","journal-title":"Surg Endosc."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1097\/SLA.0b013e3182a1599b","article-title":"Acute cholecystitis: Early versus delayed chol-ecystectomy, a multicenter randomized trial (ACDC study, NCT00447304)","volume":"258","author":"Gutt","year":"2013","journal-title":"Ann. Surg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1007\/s13312-019-1535-1","article-title":"Gallbladder Disease in Children: A 20-year Single-center Expe-rience","volume":"2","author":"Pogorelic","year":"2019","journal-title":"Indian Pediatr."},{"key":"ref_37","first-page":"1","article-title":"2016 WSES guidelines on acute calculous cholecystitis","volume":"11","author":"Ansaloni","year":"2016","journal-title":"World J. Emerg. Surg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1148\/rg.272055148","article-title":"MR Imaging of Acute Biliary Disorders","volume":"27","author":"Watanabe","year":"2007","journal-title":"Radiographics"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1097\/00004728-199807000-00025","article-title":"The Diagnostic Utility of HASTE MRI in the Evaluation of Acute Cholecystitis","volume":"22","author":"Regan","year":"1998","journal-title":"J. Comput. Assist. Tomogr."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/11\/3\/383\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:27:53Z","timestamp":1760160473000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/11\/3\/383"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,24]]},"references-count":39,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021,3]]}},"alternative-id":["diagnostics11030383"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics11030383","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,24]]}}}