SELSI Consensus Statement for Safe Cholecystectomy-Prevention and Management of Bile Duct Injury-Part B
SELSI Consensus Statement for Safe Cholecystectomy-Prevention and Management of Bile Duct Injury-Part B
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DOI：
10.1007/s12262-019-01994-1
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发表时间：
2019-12-24
影响因子：
0.4
通讯作者：
Kapoor, V. K.
中科院分区：
文献类型：
--
作者：
Bansal, Virinder Kumar;Misra, Mahesh C.;Kapoor, V. K.
胆囊切除术是印度各地最常见的普通外科手术之一。腹腔镜胆囊切除术期间胆管损伤 (BDI) 的风险比开腹胆囊切除术高两到三倍。全球胆管损伤的发生率为 0.5%，即每 200 例中就有 1 例发生。 BDI 及其后果会导致严重的发病率，甚至可能导致死亡。 BDI 增加了治疗成本，也是针对外科医生提起法医学诉讼的常见原因。为了最大限度地减少 BDI 的发生率并及时、适当地进行管理，在 2016 年印度内窥镜和腹腔镜外科医生协会 (SELSI) 会议上，一群资深外科医生认为有必要制定一套指南。其他国际协会制定的“安全腹腔镜胆囊切除术”和胆管损伤处理指南已经可用。这些指南对印度受试者（尤其是小型外围中心）的适用性有限。因此，决定为具有基本腹腔镜技能但很少或没有高级腹腔镜技能的普通外科医生制定一套指南。在塔卢卡斯或地区的个体诊所、疗养院和小型私立医院工作的人员应有适合其情况的“安全胆囊切除术”指南和 BDI 管理。这些指南是在三次共识会议后形成的，并已得到 SELSI 专家组的批准。
Cholecystectomy is one of the commonest general surgical procedures performed all over India. The risk of bile duct injury (BDI) during laparoscopic cholecystectomy is two to three times higher than during open cholecystectomy. The worldwide incidence of bile duct injury is 0.5% or 1 in 200 cases. BDI and its consequences result in significant morbidity and may even cause mortality. BDI increases the cost of treatment and is a common reason for a medicolegal suit against the surgeons. To minimize the incidence of BDI and to manage it timely and appropriately, a set of guidelines was deemed necessary by a group of senior surgeons during a Society of Endoscopic and Laparoscopic Surgeons of India (SELSI) meeting in 2016. Guidelines for "Safe Laparoscopic Cholecystectomy" and bile duct injury management formulated by other international societies are already available. The applicability of these guidelines to Indian subjects especially in small peripheral centers was limited. Hence, a decision was taken to form a set of guidelines for general surgeons with basic laparoscopic skills with little or no advanced laparoscopic skills. Those working in a solo practice, nursing homes, and small private hospitals at talukas or districts should have "Safe Cholecystectomy" guidelines and management of BDI suitable to their situation. These guidelines were formed after three consensus meetings and have been approved by a SELSI Expert Group.