Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore; Surgery Academic Clinical Programme, Duke-National University of Singapore Medical School, Singapore.
Baxter Healthcare (Asia) Pte Ltd, Singapore.
HPB (Oxford). 2023 Sep;25(9):1121-1125. doi: 10.1016/j.hpb.2023.04.015. Epub 2023 Apr 29.
The Validated Intraoperative Bleeding (VIBe) Scale could be used to aid assessment of intraoperative bleeding and guide the use of hemostatic products. The aim of this survey was to determine if the VIBe scale would serve as a generalizable and relevant tool for hepatopancreatobiliary(HPB) surgeons and trainees.
A standardized online VIBe training module was conducted on 67 respondents from 25 countries, after which they used the VIBe scale to score videos depicting different severities of intraoperative bleeding. Interobserver agreement was assessed using Kendall's coefficient of concordance.
Interobserver agreement was excellent amongst all respondents with a Kendall's W of 0.923. Sub-analyses showed a difference based on seniority and level of experience: Attendings/Consultants(0.947) vs Fellows/Residents(0.879); Increasing years of practice >10(0.952) vs <10 years practice(0.890). There was excellent concordance regardless of surgical volume, percentage of procedures performed minimally invasively, area of sub-specialty, and previous involvement with VIBe surveys.
This international survey in the field of HPB surgery across surgeons of various levels of experience showed that the VIBe scale could serve as an excellent tool to assess the severity of bleeding. This scale would also be useful in guiding the use and choice of hemostatic adjuncts to achieve hemostasis.
验证术中出血（VIBe）量表可用于辅助评估术中出血情况并指导止血产品的使用。本研究旨在确定 VIBe 量表是否可作为一种适用于肝胆胰外科医生和学员的通用且相关的工具。
对来自 25 个国家的 67 名受访者进行了标准化的在线 VIBe 培训模块，之后他们使用 VIBe 量表对不同严重程度的术中出血视频进行评分。采用 Kendall 协和系数评估观察者间一致性。
所有受访者的观察者间一致性均非常好，Kendall W 值为 0.923。亚组分析显示，一致性存在差异与资历和经验水平有关：主治医生/顾问（0.947）vs 住院医师/研究员（0.879）；实践年限 >10 年（0.952）vs <10 年（0.890）。无论手术量、微创治疗比例、亚专科领域、之前是否参与 VIBe 调查，均具有极好的一致性。
本项针对不同经验水平肝胆胰外科医生的国际调查表明，VIBe 量表可作为评估出血严重程度的优秀工具。该量表在指导止血辅助剂的使用和选择以实现止血方面也将非常有用。
