The critical view of safety and bile duct injuries in laparoscopic cholecystectomy: a photo evaluation study on 1532 patients
| Autor: | Petra Terho, Hanna Lampela, Jukka Harju, Laura Koskenvuo, Panu Mentula, Ville Sallinen |
|---|---|
| Přispěvatelé: | Faculty of Medicine, II kirurgian klinikka, HUS Abdominal Center, Clinicum, Pertti Panula / Principal Investigator, Department of Anatomy, University of Helsinki, IV kirurgian klinikka, Department of Surgery |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Abdominal Injuries Bile Duct Diseases 03 medical and health sciences Postoperative Complications fluids and secretions 0302 clinical medicine medicine Acute cholecystitis Humans In patient Laparoscopic cholecystectomy COMPLICATIONS Hepatology Bile duct business.industry Cystic Duct Gastroenterology Postoperative complication 3126 Surgery anesthesiology intensive care radiology equipment and supplies medicine.disease 3. Good health Surgery medicine.anatomical_structure Cholecystectomy Laparoscopic 3121 General medicine internal medicine and other clinical medicine 030220 oncology & carcinogenesis Cholecystitis Photo documentation Cystic duct 030211 gastroenterology & hepatology Bile Ducts business |
| Zdroj: | HPB. 23:1824-1829 |
| ISSN: | 1365-182X |
| DOI: | 10.1016/j.hpb.2021.04.017 |
| Popis: | Background: Laparoscopic cholecystectomy (LCC) carries a 0.3-1.8% risk of bile duct injury (BDI). This study investigated if intraoperative photo documentation of the critical view of safety (CVS) is related to lower rates of BDIs and postoperative complications in LCC. Methods: Surgeons were instructed to take photos of the view before clipping the cystic duct and artery. Two independent raters scored the photos 0-6 using predefined criteria for CVS. Mean scores of >= 4.5 were satisfactory. Results: The study consisted of 1532 patients undergoing LCC between April 2018 and October 2019. CVS was satisfactory in 354 (23.1%), unsatisfactory in 823 (53.7%), and photos were missing in 355 (23.2%) patients. Patients with satisfactory CVS had the lowest BDI rate compared with unsatisfactory CVS or missing photos (0.3% vs. 1.0% vs. 2.3%, p = 0.012). Four major BDIs (Strasberg D-E) occurred, but none in patients with satisfactory CVS. Patients with satisfactory CVS had the lowest postoperative complication rate compared with patients with unsatisfactory CVS or without photos (4.8% vs. 7.9 vs. 9.9%, p = 0.011). Of patients with acute cholecystitis, 15.7% had satisfactory CVS, whereas 26.8% without cholecystitis had satisfactory CVS (p < 0.001). Conclusion: Intraoperative photo documentation of satisfactory CVS is associated with lower rates of BDIs and complications. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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