Shaper N J, Harrison M, Bates T
William Harvey Hospital, Ashford, Kent.
Ann R Coll Surg Engl. 1996 Jan;78(1):39-42.
All cholecystectomies in a single health district were studied during a 5-year period spanning the introduction of laparoscopic cholecystectomy (LC). The number of LCs increased from 2 (1.3%) in year 3 to 86 (56%) in year 5. The number of operative cholangiograms and explorations of the common bile duct performed both fell substantially. The age distribution did not change significantly during the study period, but the percentage of females undergoing cholecystectomy increased. The percentage of trainee operations remained constant in those Firms performing only open cholecystectomy (OC), but fell from 67% to 9% in those adopting LC. An increase in annual cholecystectomy rate was seen with the laparoscopic surgeons, with a corresponding fall for those surgeons performing only OC. There was a threefold increase in the percentage of operations performed privately from years 2 to 5, with 73% being laparoscopic in year 5. The consequences for training of the introduction of LC must be addressed.
在引入腹腔镜胆囊切除术（LC）后的5年期间，对单一健康区的所有胆囊切除术进行了研究。LC的数量从第3年的2例（1.3%）增加到第5年的86例（56%）。术中胆管造影和胆总管探查的次数均大幅下降。研究期间年龄分布没有显著变化，但接受胆囊切除术的女性比例增加。仅进行开腹胆囊切除术（OC）的科室中，实习医生手术的比例保持不变，但在采用LC的科室中，这一比例从67%降至9%。腹腔镜手术医生的年度胆囊切除术率有所上升，而仅进行OC的医生的手术率相应下降。从第2年到第5年，私人进行的手术比例增加了两倍，第5年73%的手术为腹腔镜手术。必须解决引入LC对培训的影响。
