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巡回外科医生——新西兰北地地区腹腔镜胆囊切除术的临床审计

Travelling surgeons--a clinical audit of laparoscopic cholecystectomy procedures in Northland, New Zealand.

作者信息

Ryan Shaun M, Milsom Peter, Yang Joseph, Snyman Gerrie

机构信息

Department of Surgery, Northland DHB, Whangarei, New Zealand.

出版信息

N Z Med J. 2009 Oct 30;122(1305):34-40.

Abstract

AIM

The aim of this study was to assess the safety of laparoscopic cholecystectomy surgery performed in a peripheral hospital by travelling surgeons.

METHODS

A retrospective audit of laparoscopic cholecystectomy operations performed in Kaitaia hospital was completed and compared with international literature. Data was collected for procedures completed between March 2005 and August 2006. Information on patient demographics, admission, diagnosis, and length of stay were gathered, as well as information regarding complications of stump leak, conversion rate to open cholecystectomy, infection, postoperative Endoscopic Retrograde Cholangio Pancreatogram (ERCP) requirement and death.

RESULTS

149 laparoscopic cholecystectomies were performed in Kaitaia. Conversion to open was 5.4%. When all complications were compared no statistically significant difference could be found between complication rates in Kaitaia and those in international literature in almost all categories studied. Common Bile Duct (CBD) injury in Kaitaia was found to be lower than that reported in international literature.

CONCLUSIONS

Laparoscopic cholecystectomies are performed safely in Kaitaia hospital by travelling surgeons. Surgery performed in Kaitaia showed low complication rates, even by international standards. This is not surprising given the high number of elective operations.

摘要

目的

本研究旨在评估巡回外科医生在外围医院进行腹腔镜胆囊切除术的安全性。

方法

完成了对在凯塔亚医院进行的腹腔镜胆囊切除术的回顾性审计,并与国际文献进行比较。收集了2005年3月至2006年8月期间完成手术的数据。收集了患者人口统计学、入院、诊断和住院时间等信息,以及有关残端渗漏并发症、转为开腹胆囊切除术的转化率、感染、术后内镜逆行胰胆管造影(ERCP)需求和死亡的信息。

结果

在凯塔亚进行了149例腹腔镜胆囊切除术。转为开腹手术的比例为5.4%。在几乎所有研究类别中,比较所有并发症时,凯塔亚的并发症发生率与国际文献中的并发症发生率之间未发现统计学上的显著差异。发现凯塔亚的胆总管(CBD)损伤低于国际文献报道的水平。

结论

巡回外科医生在凯塔亚医院安全地进行腹腔镜胆囊切除术。即使按照国际标准,在凯塔亚进行的手术并发症发生率也很低。鉴于择期手术数量众多,这并不奇怪。

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