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安全的批判性观点能否预防胆损伤的出现?一项调查分析。

THE CRITICAL VIEW OF SAFETY PREVENTS THE APPEARANCE OF BILIARY INJURIES? ANALYSIS OF A SURVEY.

作者信息

Giménez Mariano Eduardo, Houghton Eduardo Javier, Zeledón Manuel E, Palermo Mariano, Acquafresca Pablo, Finger Caetano, Serra Edgardo

机构信息

University of Buenos Aires, President DAICIM Foundation.

Mini-Invasive Surgery, Hospital Bernardino Rivadavia, University of Buenos Aires, Staff DAICIM Foundation.

出版信息

Arq Bras Cir Dig. 2018;31(2):e1380. doi: 10.1590/0102-672020180001e1380. Epub 2018 Jul 2.

Abstract

BACKGROUND

The risk of bile duct injury (BDI) during cholecystectomy remains a concern, despite efforts proposed for increasing safety. The Critical View of Safety (CVS) has been adopted promoting to reduce its risk.

AIM

To perform a survey to assess the awareness of the CVS, estimating the proportion of surgeons that correctly identified its elements and its relationship with BDI.

METHODS

An anonymous online survey was sent to 2096 surgeons inquiring on their common practices during cholecystectomy and their knowledge of the CVS.

RESULTS

A total of 446 surgeons responded the survey (21%). The percentage of surgeons that correctly identified the elements of CVS was 21.8% and 24.8% among surgeons claiming to know the CVS. The percentage of surgeons that reported BDI was higher among those that incorrectly identified the elements of the CVS (p=0.03). In the multivariate analysis, career length was the most significant factor related to BDI (p=0.002).

CONCLUSIONS

The percentage of surgeons that correctly identified the Critical View of Safety was low, even among those who claimed to know the CVS. The percentage of surgeons that reported BDI was higher among those that incorrectly identified the elements of the CVS.

摘要

背景

尽管已采取措施提高安全性,但胆囊切除术中胆管损伤(BDI)的风险仍然令人担忧。安全关键视野(CVS)已被采用以降低其风险。

目的

进行一项调查,以评估对CVS的认知度,估计正确识别其要素以及其与BDI关系的外科医生比例。

方法

向2096名外科医生发送了一份匿名在线调查问卷,询问他们在胆囊切除术中的常见做法以及他们对CVS的了解。

结果

共有446名外科医生回复了调查(21%)。在声称了解CVS的外科医生中,正确识别CVS要素的比例分别为21.8%和24.8%。在错误识别CVS要素的外科医生中,报告BDI的比例更高(p=0.03)。在多变量分析中,职业生涯长度是与BDI相关的最显著因素(p=0.002)。

结论

即使在声称了解CVS的外科医生中,正确识别安全关键视野的比例也很低。在错误识别CVS要素的外科医生中,报告BDI的比例更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb85/6044193/67361b86f29e/0102-6720-abcd-31-02-e1380-gf1.jpg

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