Department of Anaesthesiology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; Auckland City Hospital, Auckland, New Zealand.
HPB (Oxford). 2018 Sep;20(9):786-794. doi: 10.1016/j.hpb.2018.03.004. Epub 2018 Apr 9.
Consistent measurement and reporting of outcomes, including adequately defined complications, is important for the evaluation of surgical care and the appraisal of new surgical techniques. The range of complications reported after LC has not been evaluated. This study aimed to identify the range of complications currently reported for laparoscopic cholecystectomy (LC), and the adequacy of their definitions.
MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched for prospective studies reporting clinical outcomes of LC, between 2013 and 2016.
In total 233 studies were included, reporting 967 complications, of which 204 (21%) were defined. One hundred and twenty-two studies (52%) did not provide definitions for any of the complications reported. Conversion to open cholecystectomy was the most commonly reported complication, reported in 135 (58%) studies, followed by bile leak in 89 (38%) and bile duct injury in 75 (32%). Mortality was reported in 89 studies (38%).
Considerable variation was identified between studies in the choice of measures used to evaluate the complications of LC, and in their definitions. A standardised set of core outcomes of LC should be developed for use in clinical trials and in evaluating the performance of surgical units.
一致的测量和报告结果,包括充分定义的并发症,对于评估手术护理和评估新的手术技术非常重要。LC 后报告的并发症范围尚未得到评估。本研究旨在确定目前报告的腹腔镜胆囊切除术 (LC) 的并发症范围,以及其定义的充分性。
在 2013 年至 2016 年间,对报告 LC 临床结果的前瞻性研究进行了 MEDLINE、EMBASE 和 Cochrane 中央对照试验注册中心的检索。
共纳入 233 项研究,报告了 967 种并发症,其中 204 种(21%)有定义。122 项研究(52%)没有为报告的任何并发症提供定义。中转开腹胆囊切除术是最常见的报告并发症,在 135 项研究(58%)中报告,其次是胆漏(89 项,38%)和胆管损伤(75 项,32%)。89 项研究(38%)报告了死亡率。
在所使用的评估 LC 并发症的措施选择以及定义方面,研究之间存在相当大的差异。应制定一套标准化的 LC 核心结局,用于临床试验和评估外科单位的表现。