Bogacki Paweł, Krzak Jan, Gotfryd-Bugajska Katarzyna, Szura Mirosław
Department of Clinical and Experimental Surgery, Jagiellonian University Medical College, Krakow, Poland.
Department of Surgery, South Jutland Hospital, Aabenraa, Denmark.
Wideochir Inne Tech Maloinwazyjne. 2020 Mar;15(1):80-86. doi: 10.5114/wiitm.2019.83297. Epub 2019 Mar 4.
Common bile duct injury (CBDI) is a severe complication of laparoscopic cholecystectomy (LC). To minimize its occurrence, SAGES established the Safe Cholecystectomy Program (SCP) with 6 rules to follow during surgery.
To assess the knowledge of SCP among European surgeons and their opinion on its usefulness.
Data were gathered using questionnaires during surgical conferences in Poland and Denmark. The questionnaire asked about the surgeon's experience in cholecystectomy and the number of complications in the form of CBDI. It asked about the surgeon's opinion on the usefulness of SCP rules on a 10-point scale. A comparison between specialists and residents was performed. The study has been registered in the ClinicalTrials.gov - NCT03155321.
One hundred eighty-four questionnaires were gathered. One hundred fourteen (61.96%) specialists (72.8% male, mean age: 50 years) and 70 (38.04%) residents (56% male, mean age: 34 years) completed the questionnaire. Mean work experience was 22 years among specialists and 4.5 years among residents. A high percentage of specialists have experienced CBDI (46% vs. 17% of residents, p = 0.014). More specialists are familiar with the SCP than residents (49.3% vs. 21.7%, p = 0.021). Significant differences in the mean usefulness score were observed for three rules: rules 2 and 6 were found more useful by residents (mean score: 7.07 vs. 6.01, p = 0.025 and 8.70 vs. 8.27, p < 0.001), and rule 3 was found more useful by specialists (mean: 8.73 vs. 8.36, p < 0.001).
The awareness of the SCP in Europe is low. Participants consider the rules of the SCP to be useful during surgery, although there are differences in the usefulness scores between the groups. An educational program to promote and further implement the SCP should be established.
胆总管损伤（CBDI）是腹腔镜胆囊切除术（LC）的一种严重并发症。为了尽量减少其发生，美国胃肠内镜外科医师学会（SAGES）制定了安全胆囊切除术计划（SCP），手术期间需遵循6条规则。
评估欧洲外科医生对SCP的了解程度及其对其有用性的看法。
在波兰和丹麦的外科会议期间通过问卷调查收集数据。问卷询问了外科医生的胆囊切除术经验以及以CBDI形式出现的并发症数量。它以10分制询问了外科医生对SCP规则有用性的看法。对专家和住院医师进行了比较。该研究已在ClinicalTrials.gov注册 - NCT03155321。
共收集到184份问卷。114名（61.96%）专家（72.8%为男性，平均年龄：50岁）和70名（38.04%）住院医师（56%为男性，平均年龄：34岁）完成了问卷。专家的平均工作经验为22年，住院医师为4.5年。有较高比例的专家经历过CBDI（46%，而住院医师为17%，p = 0.014）。熟悉SCP的专家比住院医师更多（49.3%对21.7%，p = 0.021）。在三条规则的平均有用性评分上观察到显著差异：住院医师认为规则2和6更有用（平均评分：7.07对6.01，p = 0.025；8.70对8.27，p < 0.001），而专家认为规则3更有用（平均：8.73对8.36，p < 0.001）。
欧洲对SCP的认知度较低。参与者认为SCP规则在手术期间有用，尽管两组之间在有用性评分上存在差异。应建立一个推广和进一步实施SCP的教育计划。
