Validation of VIBe bleeding scale amongst hepatopancreatobiliary surgeons: results from an IHPBA survey

Background: 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. Methods: 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. Results: 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. Conclusion: 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.