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为腹腔镜胆道探索提出的难度分级系统:对临床实践,培训和研究的好处

Ahmad H M Nassar^1,2,3, Mahmoud Sallam⁴, Khurram S Khan^4,5,6

¹Laparoscopic Biliary Unit, University Hospital Monklands, Airdrie, Scotland, UK. ahmad.nassar@glasgow.ac.uk.

Surgical endoscopy

|June 22, 2023

概括

腹腔镜胆道探索 (LBDE) 的新分类系统分层了难度,有助于训练和预测结果. 大多数LBDE都很容易,鼓励更广泛地采用这种单次治疗胆道结石的治疗方法.

科学领域:

胃肠病学胃肠病学
手术创新在外科创新.
胆道外科手术胆道外科手术

背景情况:

单次治疗胆道结石的治疗方法看起来有前途,但采用速度很慢.
腹腔镜胆道探索 (LBDE) 被认为是技术上要求很高,培训机会有限.

研究的目的:

根据操作特征,为LBDE开发一种新的难度分类.
为了分层术后的结果,轻松与困难的LBDE,独立于外科医生的经验.

主要方法:

分析了1335个LBDE程序的队列.
根据石头特征,检索技术和胆道病理学,分类为容易 (I-II级) 和困难 (III-V级).
包括并发症,手术时间和住院时间在内的结果在难度等级之间进行了比较.

主要成果:

72%的LBDE被归类为轻松的,其中77%完成了跨囊.
困难的探索与更高的紧急呈现率,黄,先前的缩切除术和胆管扩张有关.
加长的手术时间,并发症,住院,再入院和保留的石头与更高的难度等级相关.

结论:

拟议的LBDE难度分级系统有效预测患者的结果,并有助于比较研究结果.
这种分类可以标准化培训,并评估外科手术的学习曲线.
高比例的容易病例表明LBDE可以更广泛地被采用为单次会话胆道结石管理.

关键词:

胆固醇镜检查 (Choledochoscopy) 是一种胆固醇镜检查.胆固醇切除术是一种切除术.难度分级分类是如何进行的.受影响的胆道结石.腹腔镜胆道探索胆道探索跨纳粹主义者跨纳粹主义者擦拭机叶机动作 WBM WBM 的动作

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