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首页> 外文期刊>Surgical Endoscopy >Prevention and treatment of bile duct injuries during laparoscopic cholecystectomy: The clinical practice guidelines of the European Association for Endoscopic Surgery (EAES)
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Prevention and treatment of bile duct injuries during laparoscopic cholecystectomy: The clinical practice guidelines of the European Association for Endoscopic Surgery (EAES)

机译：腹腔镜胆囊切除术中胆管损伤的预防和治疗：欧洲内窥镜手术协会（EAES）的临床实践指南

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Background: Laparoscopic cholecystectomy is one of the most common surgical procedures in Europe (and the world) and has become the standard procedure for the management of symptomatic cholelithiasis or acute cholecystitis in patients without specific contraindications. Bile duct injuries (BDI) are rare but serious complications that can occur during a laparoscopic cholecystectomy. Prevention and management of BDI has given rise to a host of publications but very few recommendations, especially in Europe. Methods: A systematic research of the literature was performed. An international expert panel was invited to appraise the current literature and to develop evidencebased recommendations. Statements and recommendations were drafted after a consensus development conference in May 2011, followed by presentation and discussion at the annual congress of the EAES held in Torino in June 2011. Finally, full guidelines were consented and adopted by the expert panel via e-mail and web conference. Results: A total of 1,765 publications were identified through the systematic literature search and additional submission by panellists; 671 publications were selected as potentially relevant. Only 46 publications fulfilled minimal methodological criteria to support Clinical Practice Guidelines recommendations. Because the level of evidence was low for most of the studies, most statements or recommendations had to be based on consensus of opinion among the panel members. A total of 15 statements and recommendations were developed covering the following topics: classification of injuries, epidemiology, prevention, diagnosis, and management of BDI. Conclusions: Because BDI is a rare event, it is difficult to generate evidence for prevention, diagnosis, or the management of BDI from clinical studies. Nevertheless, the panel has formulated recommendations. Due to the currently limited evidence, a European registry should be considered to collect and analyze more valid data on BDI upon which recommendations can be based.
机译：背景：腹腔镜胆囊切除术是欧洲（乃至世界）最常见的外科手术之一，并且已成为治疗无特定禁忌症的有症状胆石症或急性胆囊炎的标准方法。胆管损伤（BDI）很少见，但在腹腔镜胆囊切除术中可能发生严重的并发症。 BDI的预防和管理产生了许多出版物，但很少有建议，尤其是在欧洲。方法：对文献进行系统的研究。邀请了一个国际专家小组来评估当前文献并提出基于证据的建议。在2011年5月的共识性开发会议之后，起草了声明和建议，随后在2011年6月在都灵举行的EAES年度大会上进行了介绍和讨论。最后，专家组通过电子邮件和网络会议。结果：通过系统的文献搜索和专门小组成员的补充投稿，总共确定了1,765种出版物;选择了671篇潜在相关的出版物。只有46个出版物达到了支持《临床实践指南》建议的最低方法标准。由于大多数研究的证据水平较低，因此大多数陈述或建议都必须基于小组成员之间的共识。总共制定了15项声明和建议，涉及以下主题：伤害分类，流行病学，BDI的预防，诊断和管理。结论：由于BDI是一种罕见事件，因此难以从临床研究中为BDI的预防，诊断或管理提供证据。尽管如此，小组仍提出了建议。由于目前的证据有限，应考虑建立欧洲注册机构来收集和分析可作为建议依据的关于BDI的更有效数据。

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