Bernard H R, Hartman T W
New York State Department of Health, Albany, New York 12237.
Am J Surg. 1993 Apr;165(4):533-5. doi: 10.1016/s0002-9610(05)80956-0.
After becoming alarmed about seven unusual and severe complications reported by New York State hospitals after laparoscopic cholecystectomy, the Department of Health of New York State tabulated all reported adverse incidents. After observing unusual injuries to the great vessels of the abdomen and an increase in major bile duct injury during laparoscopic cholecystectomy, the Department of Health prepared a memorandum to New York State hospitals advising closer attention to education, credentialing, proctoring, and outcome after these operations. The frequency of cholecystectomy has increased sharply, by 21%, since the advent of laparoscopic cholecystectomy. The serious injury rate may be approximately 15 times that observed after an open cholecystectomy. Recognizing the theoretic advantages of the procedure, the Department of Health reminded hospital Boards of Trustees of their obligation to establish mechanisms for credentialing and privileging surgeons and surgical teams so that the risks do not exceed those expected of the open procedure and to detect and correct deviations from this standard.
在对纽约州医院报告的腹腔镜胆囊切除术后出现的七例异常且严重的并发症感到警觉后，纽约州卫生部将所有报告的不良事件制成了表格。在观察到腹腔镜胆囊切除术中腹部大血管出现异常损伤以及主要胆管损伤增加后，卫生部向纽约州医院准备了一份备忘录，建议在这些手术后更密切地关注教育、资质认定、监督和结果。自腹腔镜胆囊切除术出现以来，胆囊切除术的频率急剧上升，增加了21%。严重损伤率可能约为开腹胆囊切除术后观察到的损伤率的15倍。卫生部认识到该手术的理论优势，提醒医院董事会有义务建立外科医生和手术团队的资质认定和特权授予机制，以使风险不超过开腹手术预期的风险，并检测和纠正偏离该标准的情况。
