Fletcher D R
University Department of Surgery, Fremantle Hospital, WA.
Med J Aust. 1995 Nov 20;163(10):535-8. doi: 10.5694/j.1326-5377.1996.tb122142.x.
Changes in the practice of surgery following the introduction of laparoscopic cholecystectomy (removing asymptomatic gallstones, duplicating procedures for diagnosing and managing common bile duct stones, and deferring laparoscopic management of complicated gallstones) as well as the increased rate of complications (particularly duct injury), have eroded the economic benefits to health care funders of shorter hospital stays. However, these benefits may be achieved if laparoscopic procedures are performed only by experienced surgeons and if the procedure is offered to all patients with gallstones, including complicated cases. Benefits to the community remain in terms of productivity savings as a result of an earlier return to work for patients.
随着腹腔镜胆囊切除术的引入（切除无症状胆结石、重复进行诊断和处理胆总管结石的操作以及推迟对复杂胆结石的腹腔镜治疗），外科手术实践发生了变化，同时并发症发生率上升（尤其是胆管损伤），这削弱了缩短住院时间给医疗保健资助者带来的经济效益。然而，如果仅由经验丰富的外科医生进行腹腔镜手术，并且将该手术提供给所有胆结石患者，包括复杂病例，那么可能会实现这些益处。由于患者能更早重返工作岗位，从而节省了生产力，这对社会仍有益处。
