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[腹腔镜胆囊切除术在教学门诊的广泛应用。300例手术的经验与结果]

[Broad use of laparoscopic cholecystectomy in the teaching clinic. Experiences and results of 300 operations].

作者信息

Bartsch D, Nies C, Rothmund M

机构信息

Klinik für Allgemeinchirurgie, Philipps-Universität Marburg.

出版信息

Chirurg. 1993 Aug;64(8):642-8.

PMID:8404292
Abstract

Laparoscopic cholecystectomy (LC) was integrated early in surgical training according to the concept "observe, assist and then operate under the assistance of an experienced surgeon". 300 LC's were performed by 27 different surgeons (8 board certified surgeons, 19 residents in the year 2-6 of training). 60.3% of all LC's and 73% of LC's performed for acute cholecystitis were done by residents. Our results including an overall complication rate of 5.3% shows, that LC can be performed by residents without additional complications or unacceptable length of operations, provided the threshold for conversion is low and the surgeon is assisted by an experienced laparoscopist. We therefore suggest that the early integration of LC in surgical training is justified.

摘要

根据“观察、协助,然后在经验丰富的外科医生协助下进行手术”的理念,腹腔镜胆囊切除术(LC)在外科培训中很早就被纳入。27位不同的外科医生(8位获得委员会认证的外科医生,19位处于培训第2至6年的住院医师)共进行了300例LC手术。所有LC手术的60.3%以及因急性胆囊炎进行的LC手术的73%是由住院医师完成的。我们的结果包括5.3%的总体并发症发生率表明,只要中转手术的阈值较低且有经验丰富的腹腔镜手术医生协助,住院医师就可以进行LC手术,而不会出现额外的并发症或手术时间过长的情况。因此,我们建议在外科培训中早期纳入LC手术是合理的。

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