Establishing consensus on the perioperative management of cholecystectomy in public hospitals: a Delphi study with an expert panel in Mexico.

Autor:	Romero RJ; Department of Bariatric & Metabolic Surgery, Spanish Hospital of Veracruz, 16 de Septiembre 955 Col. Centro, 91700, Veracruz, Ver., Mexico. Electronic address: rey_@hotmail.com., Martinez-Mier G; Department of Hepato-Biliary Surgery & Transplantation, High Speciality Medical Unit 14, Mexican Institute of Social Security, Cuahutémoc Col. Formando Hogar, 91810, Veracruz, Ver., Mexico., Ayala-García MA; Department of Surgery & Research, General Hospital Zone 58, Mexican Institute of Social Security, Boulevard Jorge Vértiz Campero 1949 Col, San Miguel de Rentería, 37238, León, Gto., Mexico., Beristain-Hernández JL; Department of Hepato-Biliary Surgery, National Medical Center 'Antonio Fraga Mouret, La Raza', Seris y Zaachila Col. La Raza, 02990, Mexico City, Mexico., Chan-Nuñez LC; Department of Hepato-Biliary Surgery, National Institute of Medical Sciences and Nutrition 'Salvador Zubirán', Vasco de Quiróga 15 Col. Belisario Dominguez, 14080, Mexico City, Mexico., Chapa-Azuela O; Department of Hepato-Pancreato-Biliary Surgery, General Hospital of Mexico 'Dr. Eduardo Liceaga', Dr. Balmis 148 Col. Doctores, 06720, Mexico City, Mexico., Dominguez-Rosado I; Department of Hepato-Biliary Surgery, National Institute of Medical Sciences and Nutrition 'Salvador Zubirán', Vasco de Quiróga 15 Col. Belisario Dominguez, 14080, Mexico City, Mexico., Flores-Villalba E; Department of Hepato-Biliary Surgery & Transplantation, Zambrano Hellion Medical Center Monterrey Institute of Technology and Higher Education, Batallón de San Patricio 112 Col. Real San Agustín, 66278, San Pedro Garza García, N.L., Mexico., Fuentes-Orozco C; Department of Surgery & Research, Western National Medical Center, Mexican Institute of Social Security, Belisario Dominguez 1000 Col. Belisario Dominguez, 44329, Guadalajara, Jal., Mexico., García-Covarrubias L; Department of Transplantation, General Hospital of Mexico 'Dr. Eduardo Liceaga', Dr. Balmis 148 Col. Doctores, 06720, Mexico City, Mexico., González-Ojeda A; Department of Surgery & Research, Western National Medical Center, Mexican Institute of Social Security, Belisario Dominguez 1000 Col. Belisario Dominguez, 44329, Guadalajara, Jal., Mexico., Herrera-Hernández MF; Department of Endocrine Surgery, National Institute of Medical Sciences and Nutrition 'Salvador Zubirán', Vasco de Quiróga 15 Col. Belisario Dominguez, 14080, Mexico City, Mexico., Martinez-Ordaz JL; Department of Surgery, XXI Century National Medical Center, Mexican Institute of Social Security, Av. Cuahutémoc 33 Col. Doctores, 06720, Mexico City, Mexico., Medina-Franco H; Department of Surgical Oncology, National Institute of Medical Sciences and Nutrition 'Salvador Zubirán', Vasco de Quiróga 15 Col. Belisario Dominguez, 14080, Mexico City, Mexico., Mercado MA; Department of Surgery, National Institute of Medical Sciences and Nutrition 'Salvador Zubirán', Vasco de Quiróga 15 Col. Belisario Dominguez, 14080, Mexico City, Mexico., Montalvo-Jave E; Department of Hepato-Pancreato-Biliary Surgery, General Hospital of Mexico 'Dr. Eduardo Liceaga', Dr. Balmis 148 Col. Doctores, 06720, Mexico City, Mexico., Nuño-Guzmán CM; Department of Surgery, Civil Hospital 'Fray Antonio Alcalde', Hospital 278 Col. El Retiro, 44280, Guadalajara, Jal., Mexico., Torices-Escalante E; Department of Gastrointestinal Endoscopy, Regional Hospital October 1st, Institute for Social Security and Services for State Workers, Av. Politécnico Nacional 1669 Col. Magdalena de las Salinas, 07300, Mexico City, Mexico., Torres-Villalobos GM; Department of Experimental Surgery & Minimally Invasive Surgery, National Institute of Medical Sciences and Nutrition 'Salvador Zubirán', Vasco de Quiróga 15 Col. Belisario Dominguez, 14080, Mexico City, Mexico., Vilatoba-Chapa M; Department of Transplantation, National Institute of Medical Sciences and Nutrition 'Salvador Zubirán', Vasco de Quiróga 15 Col. Belisario Dominguez, 14080, Mexico City, Mexico., Zamora-Godinez J; Department of Surgery, General Hospital Zone 8, Mexican Institute of Social Security, Calle 18 de julio 214 Col. Periodistas, 42060, Pachuca, Hgo., Mexico., Zapata-Chavira H; Department of Surgery & Transplantation, University Hospital 'Dr. José E. González', Av. Gonzalitos 235 Col. Mitras Centro, 64460, Monterrey, N.L., Mexico., Zerrweck-Lopez C; Department of Bariatric & Metabolic Surgery, Tláhuac General Hospital, Av. La Turba 655 Col. Villa Centroamericana, 13250, Mexico City, Mexico.
Jazyk:	angličtina
Zdroj:	HPB : the official journal of the International Hepato Pancreato Biliary Association [HPB (Oxford)] 2021 May; Vol. 23 (5), pp. 685-699. Date of Electronic Publication: 2020 Oct 16.
DOI:	10.1016/j.hpb.2020.09.021
Abstrakt:	Background: Several guidelines have put forward recommendations about the perioperative process of cholecystectomy. Despite the recommendations, controversy remains concerning several topics, especially in low- and middle-income countries. The aim of this study was to develop uniform recommendations for perioperative practices in cholecystectomy in Mexico to standardize this process and save public health system resources. Methods: A modified Delphi method was used. An expert panel of 23 surgeons anonymously completed two rounds of responses to a 29-item questionnaire with 110 possible answers. The consensus was assessed using the percentage of responders agreeing on each question. Results: From the 29 questions, the study generated 27 recommendations based on 20 (69.0%) questions reaching consensus, one that was considered uncertain (3.4%), and six (20.7%) items that remained open questions. In two (6.9%) cases, no consensus was reached, and no recommendation could be made. Conclusions: This study provides recommendations for the perioperative management of cholecystectomy in public hospitals in Mexico. As a guide for public institutions in low- and middle-income countries, the study identifies recommendations for perioperative tests and evaluations, perioperative decision making, postoperative interventions and institutional investment, that might ensure the safe practice of cholecystectomy and contribute to conserving resources. (Copyright © 2020 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.)
Databáze:	MEDLINE
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