遗弃胆囊切除术:2013-2024年单中心回顾性横断面队列研究

IF 1.1 4区 医学 Q3 SURGERY
Raimundas Lunevicius, Stephen W Fenwick
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引用次数: 0

摘要

摘要:放弃胆囊切除术(AbC)是胆囊手术中一种很少被研究的救助手术。本研究旨在估计AbC的年使用率,提供AbC特定的临床结果数据,并在更广泛的背景下讨论AbC相关主题。材料和方法:本回顾性横断面研究在一所大学医院进行,纳入2013年至2023年间接受AbC手术的患者。最后一次随访于2024年1月31日进行。使用探索性数据分析对数据集进行调查。结果:女性20例,男性17例,平均年龄62.5岁。择期手术的平均AbC率为1%。慢性囊周炎性肿块是AbC最常见的病因(n = 22;59.5%)。术后30天的结果包括住院时间延长(中位数,2),再入院率为18.9%(4次急诊;计划3例),二次手术率13.5%(急诊2例;计划3例),医源性损伤发生率5.4%(2例)。长期结局包括6例急性胆胰事件急诊入院(16.7%)。择期二期胆囊手术15例,其中全胆囊切除术11例,次全胆囊切除术3例(占20%),胆囊取石合并胆囊管造瘘1例。结论:AbC在大多数情况下是可以预防的。关键是要遵守急性结石性胆囊炎的治疗指南。当其他控制损害和限制手术的选择不可行时,应及早决定将腹腔镜手术改为开放或放弃胆囊切除术,以避免腹腔镜手术暴露胆囊带来的负担。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Abandoned Cholecystectomy: A Single-Center Retrospective Cross-Sectional Cohort Study, 2013-2024.

Introduction: Abandoned cholecystectomy (AbC) is a rarely studied bailout procedure in gallbladder surgery. This study aimed to estimate the annual utilization rates of AbC, provide AbC-specific clinical outcome data, and discuss AbC-related themes in a broader context. Materials and Methods: This retrospective cross-sectional study was conducted at a university hospital and comprised patients who underwent AbC between 2013 and 2023. The final follow-up was conducted on January 31, 2024. The dataset was investigated using exploratory data analysis. Results: In total, 20 female and 17 male patients (mean age, 62.5 years) underwent AbC. The mean AbC rate in the elective surgery setting was 1%. A chronic pericholecystic inflammatory mass was the most common cause of AbC (n = 22; 59.5%). The 30-day postoperative outcomes included a prolonged length of hospital stay (median, 2), readmission rate of 18.9% (four emergencies; three planned), second surgical procedure rate of 13.5% (two emergencies; three planned), and iatrogenic injury rate of 5.4% (2 patients). Long-term outcomes included six emergency admissions with acute biliopancreatic events (16.7%). Fifteen patients underwent elective secondary gallbladder surgeries, including 11 total cholecystectomies, three subtotal cholecystectomies (20%), and one cholecystolithotomy with tube cholecystostomy. Conclusions: AbC is preventable in most cases. Adherence to guidelines for managing acute calculous cholecystitis is the key. The decision to convert laparoscopic surgery to open or bail out by abandoning cholecystectomy when other options for damage control and limitation surgery are infeasible should be made early to avoid the burden associated with laparoscopic surgery to expose the gallbladder.

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来源期刊
CiteScore
2.90
自引率
0.00%
发文量
163
审稿时长
3 months
期刊介绍: Journal of Laparoendoscopic & Advanced Surgical Techniques (JLAST) is the leading international peer-reviewed journal for practicing surgeons who want to keep up with the latest thinking and advanced surgical technologies in laparoscopy, endoscopy, NOTES, and robotics. The Journal is ideally suited to surgeons who are early adopters of new technology and techniques. Recognizing that many new technologies and techniques have significant overlap with several surgical specialties, JLAST is the first journal to focus on these topics both in general and pediatric surgery, and includes other surgical subspecialties such as: urology, gynecologic surgery, thoracic surgery, and more.
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