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住院医师毕业后年份对腹腔镜胆囊切除术结果的影响。

Impact of Resident Post-Graduate Year on Laparoscopic Cholecystectomy Outcomes.

作者信息

Bourakkadi Idrissi Mehdi, El Bouhaddouti Hicham, Mouaqit Ouadii, Ousadden Abdelmalek, Benjelloun El Bachir

机构信息

Department of Visceral Surgery, Hassan II University Hospital, Fez, MAR.

出版信息

Cureus. 2023 Mar 24;15(3):e36644. doi: 10.7759/cureus.36644. eCollection 2023 Mar.

Abstract

Introduction Laparoscopic cholecystectomy is a minimal access procedure in which the gallbladder is removed by laparoscopic techniques. Effective training for laparoscopic surgery should focus on not only understanding the anatomy and procedural steps but also acquiring the specific gestures and techniques of this type of surgery that may differ from those used in traditional open surgery. The aim of our study was to analyze whether the laparoscopic cholecystectomy performed by surgeons in training is a safe procedure. Material and methods This is a retrospective review of 433 patients who were divided into two groups: laparoscopic cholecystectomies performed by trainees and those performed by senior surgeons. Results Around 66% of surgeries were performed by resident surgeons. There was no demographic difference between residents and senior surgeons. Operative time was significantly longer in the residents' group compared to senior surgeons' group (96 minutes vs 61 minutes; p<0.001). The overall intra- and post-operative complication rates were 3.1% and 2.5%, respectively, with no significant difference between the two groups (p=0.368 and p=0.223). Conversion to open laparotomy was required in 8% of cases in each group (p=0.538). The mean length of hospital stay after surgery was significantly longer in patients operated by residents (p<0.001). We did not notice any case of mortality in both groups.

摘要

引言 腹腔镜胆囊切除术是一种微创手术,通过腹腔镜技术切除胆囊。腹腔镜手术的有效培训不仅应注重理解解剖结构和手术步骤,还应掌握这类手术特有的手势和技巧,这些可能与传统开放手术有所不同。我们研究的目的是分析接受培训的外科医生进行的腹腔镜胆囊切除术是否安全。

材料与方法 这是一项对433例患者的回顾性研究,患者被分为两组:由实习医生进行的腹腔镜胆囊切除术和由资深外科医生进行的腹腔镜胆囊切除术。

结果 约66%的手术由住院医生完成。住院医生和资深外科医生在人口统计学特征上没有差异。住院医生组的手术时间明显长于资深外科医生组(96分钟对61分钟;p<0.001)。两组的总体术中和术后并发症发生率分别为3.1%和2.5%,两组之间无显著差异(p=0.368和p=0.223)。每组各有8%的病例需要转为开腹手术(p=0.538)。住院医生进行手术的患者术后平均住院时间明显更长(p<0.001)。两组均未发现死亡病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eab8/10122960/977dba7abc17/cureus-0015-00000036644-i01.jpg

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