Who should perform laparoscopic cholecystectomy? A 10-year audit
Who should perform laparoscopic cholecystectomy? A 10-year audit
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DOI：
10.1007/s00464-007-9291-z
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发表时间：
2007-09-01
影响因子：
3.1
通讯作者：
Rhodes, M.
中科院分区：
文献类型：
--
作者：
Boddy, A. P.;Bennett, J. M. H.;Rhodes, M.
背景：腹腔镜胆囊切除术是普外科最常见的手术之一。它是由外科医生在胆道疾病的专业利益，以及由外科医生与其他专业interests.Methods：所有胆囊切除术的回顾性审计进行了一个单一的医院在10年期间，从1996年至2005年。从两个独立的电子数据库中提取数据，并通过对术后住院时间延长或计划外再入院病例的完整记录进行审查进行补充。将上消化道（GI）专家顾问护理下的病例结果与其他公司的普通外科顾问的病例结果进行比较。腹腔镜胆囊切除术在上消化道手术中的应用率更高（96.2%比80.1%），术中胆道造影的应用率更高（83.4%比16.9%）。上消化道病例的平均手术时间较短（69 vs 84 min），术后住院时间也较短（2 vs 3.6 d）。上消化道病例中胆管损伤的发生率也显著降低（0.1% vs 0.9%）。结论：在他们的机构中，作者发现在上消化道或肝胰胆管外科专家的护理下进行腹腔镜胆囊切除术时，结果改善的证据。
Background: Laparoscopic cholecystectomy is one of the most common operations in general surgery. It is performed by surgeons with a specialist interest in biliary disease as well as by surgeons with other specialist interests.Methods: This retrospective audit of all cholecystectomies was conducted in a single hospital over a 10-year period from 1996 to 2005. Data were extracted from two independent electronic databases and supplemented by a full note review of cases with extended postoperative stay or unplanned readmission. The outcomes for cases under the care of specialist upper gastrointestinal (GI) consultants were compared with outcomes for cases of general surgery consultants from other firms.Results: Data from 4,139 cholecystectomies were obtained. More cholecystectomies performed by upper GI firms were completed laparoscopically (96.2% vs 80.1%) with a higher rate of intraoperative cholangiograms (83.4% vs 16.9%). The mean operating time was shorter for upper GI cases (69 vs 84 min), as was the postoperative hospital stay (2 vs 3.6 days). There also was a significantly lower incidence of bile duct injury in upper GI cases (0.1% vs 0.9%).Conclusion: In their institution, the authors found evidence of improved outcomes when laparoscopic cholecystectomy was performed under the care of surgeons with a specialist interest in upper GI or hepatopancreaticobiliary surgery.