Sobocki Jacek, Pędziwiatr Michał, Bigda Justyna, Hołówko Wacław, Major Piotr, Mitura Kryspin, Myśliwiec Piotr, Nowosad Małgorzata, Obcowska-Hamerska Aneta, Orłowski Michał, Proczko-Stepaniak Monika, Szeliga Jacek, Wallner Grzegorz, Zawadzki Marek, Banasiewicz Tomasz, Budzyński Andrzej, Dziki Adam, Grąt Michał, Jackowski Marek, Kielan Wojciech, Matyja Andrzej, Paśnik Krzysztof, Richter Piotr, Szczepanik Antoni, Szura Mirosław, Tarnowski Wiesław, Zieniewicz Krzysztof
Chair and Department of General Surgery and Clinical Nutrition, Medical Center of Postgraduate Education Warsaw, Warsaw, Poland.
2 Department of General Surgery, Jagiellonian University, Collegium Medicum, Krakow, Poland.
Wideochir Inne Tech Maloinwazyjne. 2023 Jun;18(2):187-212. doi: 10.5114/wiitm.2023.127877. Epub 2023 Jun 2.
Over the past three decades, almost every type of abdominal surgery has been performed and refined using the laparoscopic technique. Surgeons are applying it for more procedures, which not so long ago were performed only in the classical way. The position of laparoscopic surgery is therefore well established, and in many operations it is currently the recommended and dominant method.
The aim of the preparation of these guidelines was to concisely summarize the current knowledge on laparoscopy in acute abdominal diseases for the purposes of the continuous training of surgeons and to create a reference for opinions.
The development of these recommendations is based on a review of the available literature from the PubMed, Medline, EMBASE and Cochrane Library databases from 1985 to 2022, with particular emphasis on systematic reviews and clinical recommendations of recognized scientific societies. Recommendations were formulated in a directive form and evaluated by a group of experts using the Delphi method.
There are 63 recommendations divided into 12 sections: diagnostic laparoscopy, perforated ulcer, acute pancreatitis, incarcerated hernia, acute cholecystitis, acute appendicitis, acute mesenteric ischemia, abdominal trauma, bowel obstruction, diverticulitis, laparoscopy in pregnancy, and postoperative complications requiring emergency surgery. Each recommendation was supported by scientific evidence and supplemented with expert comments. The guidelines were created on the initiative of the Videosurgery Chapter of the Association of Polish Surgeons and are recommended by the national consultant in the field of general surgery. The first part of the guidelines covers 5 sections and the following challenges for surgical practice: diagnostic laparoscopy, perforated ulcer, acute pancreatitis, incarcerated hernia and acute cholecystitis. Contraindications for laparoscopy and the ERAS program are discussed.
在过去三十年中，几乎每种腹部手术都已采用腹腔镜技术进行并得到完善。外科医生正在将其应用于更多手术，而这些手术在不久前还只能通过传统方式进行。因此，腹腔镜手术的地位已稳固确立，在许多手术中，它目前是推荐的主要方法。
编写这些指南的目的是简要总结当前关于腹腔镜在急性腹部疾病中的知识，以用于外科医生的持续培训，并为形成观点提供参考。
这些建议的制定基于对1985年至2022年来自PubMed、Medline、EMBASE和Cochrane图书馆数据库的现有文献的回顾，特别强调公认科学协会的系统评价和临床建议。建议以指令形式制定，并由一组专家使用德尔菲法进行评估。
共有63条建议，分为12个部分：诊断性腹腔镜检查、穿孔性溃疡、急性胰腺炎、嵌顿疝、急性胆囊炎、急性阑尾炎、急性肠系膜缺血、腹部创伤、肠梗阻、憩室炎、妊娠中的腹腔镜检查以及需要急诊手术的术后并发症。每条建议都有科学证据支持，并附有专家评论。这些指南是在波兰外科医生协会视频外科学分会的倡议下制定的，并得到普通外科领域国家顾问的推荐。指南的第一部分涵盖5个部分以及外科实践面临的以下挑战：诊断性腹腔镜检查、穿孔性溃疡、急性胰腺炎、嵌顿疝和急性胆囊炎。讨论了腹腔镜检查的禁忌症和加速康复外科（ERAS）计划。
