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内脏外科医生和术中胆管造影术:对法国狂野西部外科医生的调查。

Visceral surgeon and intraoperative cholangiography: Survey about French Wild West surgeons.

机构信息

Service de chirurgie digestive et endocrinienne, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France.

出版信息

J Visc Surg. 2011 Oct;148(5):e385-91. doi: 10.1016/j.jviscsurg.2011.09.003. Epub 2011 Oct 22.

Abstract

Cholecystectomy is one of the most common abdominal surgical procedures. No formal agreement has been reached about the routine practice of intraoperative cholangiography (IOC). The purpose of this survey was to describe the practices and the opinions of surgeons in western France. A survey was conducted among 300 visceral surgeons practicing in western France who were asked to respond to a questionnaire with objective and subjective items. One hundred forty-eight answers were interpretable. Among these 148 surgeons, 125 (83.4%) performed IOC routinely (IOCr group) and 23 (15.4%) selectively (IOCs group). Mean age of responding surgeons was 49.3 years. Groups IOCr and IOCs were not significantly different concerning surgical experience. Surgeons in both groups responded that IOC effectively screens for intraoperative bile duct injury. In our survey, routine practice of IOC was more common than reported by our English-speaking colleagues. The routine users responded that IOC can screen for intraoperative bile duct injury or choledocholithiasis. The selective users responded that IOC has its own morbidity. IOC is commonly performed in France during laparoscopic cholecystectomy. Although it may not be indispensable, it allows rapid screening for intraoperative bile duct injury. It also provides documented proof of good surgical practice in the event of a litigation claim after bile duct injury.

摘要

胆囊切除术是最常见的腹部外科手术之一。对于术中胆管造影术(IOC)的常规应用,尚未达成正式共识。本研究旨在描述法国西部外科医生的实践和观点。我们对法国西部 300 名内脏外科医生进行了一项调查,要求他们对一份包含客观和主观项目的问卷做出回应。共收到 148 份可解释的答案。在这 148 名外科医生中,有 125 名(83.4%)常规进行 IOC(IOCr 组),23 名(15.4%)选择性进行 IOC(IOCs 组)。回答问题的外科医生的平均年龄为 49.3 岁。IOCr 组和 IOCs 组在手术经验方面无显著差异。两组外科医生均认为 IOC 可有效筛查术中胆管损伤。在我们的调查中,IOC 的常规应用比我们的英语同行报道的更为常见。常规使用者认为 IOC 可筛查术中胆管损伤或胆总管结石。选择性使用者认为 IOC 存在自身的发病率。在法国,腹腔镜胆囊切除术时经常进行 IOC。尽管它可能不是必不可少的,但它可以快速筛查术中胆管损伤。在发生胆管损伤的诉讼索赔时,它还提供了良好手术实践的书面证据。

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