Tullavardhana Thawatchai, Rookkachart Thammanij, Akranurakkul Prinya
J Med Assoc Thai. 2016 Nov;99 Suppl 8:S43-S47.
Currently, Laparoscopic cholecystectomy (LC) is the gold standard surgical treatment of stones in the gall bladder. However, the disadvantage of LC was increases in the incidence of bile duct injury up to 0.20-3.40%. The critical view of safety (CVS) technique has been developed in an attempt to prevent the complication.
To verify the adequacy of performing CVS technique by auditing the operative note, video record and photographic documentation.
From January until December 2015, we investigated the accuracy of CVS establishment on video and photo prints. Two experienced laparoscopic surgeons were independent analyzer of the documentations, which classified into conclusive, probably, inconclusive and not established.
A twenty-four patients underwent an elective LC. The video records provide a superior quality to prove the CVS than the photo prints (90-95% versus 75-80%). However, a combination of documenting modality including operative note, video and photo print proved that a conclusive CVS establishment could be achieved in all cases. There was no postoperative complication occurred in this study.
Mandatory use of the imaging documentation methods for assessment of adequate CVS generally facilitates a good quality control in surgical practice and patient care.
目前,腹腔镜胆囊切除术(LC)是胆囊结石的金标准手术治疗方法。然而,LC的缺点是胆管损伤发生率增加至0.20 - 3.40%。为预防该并发症,已开发出安全关键视野(CVS)技术。
通过审核手术记录、视频记录和照片文档来验证实施CVS技术的充分性。
2015年1月至12月,我们调查了视频和照片打印件上CVS建立的准确性。两名经验丰富的腹腔镜外科医生独立分析这些文档,将其分为确定、可能、不确定和未建立四类。
24例患者接受了择期LC。视频记录在证明CVS方面比照片打印件质量更高(90 - 95%对75 - 80%)。然而,包括手术记录、视频和照片打印件在内的记录方式相结合,证明在所有病例中都能实现确定的CVS建立。本研究中未发生术后并发症。
强制使用影像记录方法评估充分的CVS通常有助于在外科手术实践和患者护理中进行良好的质量控制。