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首页> 外文期刊>Surgical Endoscopy >Gallbladder damage control: compromised procedure for compromised patients.
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Gallbladder damage control: compromised procedure for compromised patients.

机译：胆囊损害控制：针对受损患者的受损程序。

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The objective of this study was to analyze a population-based database for (1) recent 9-year trends in utilization of partial cholecystectomy (PC), laparoscopic PC, and trocar cholecystostomy (TC), (2) demographics, associated diagnoses, and hospital characteristics, and (3) relevant inpatient outcomes.Retrospective cohort analysis of the Nationwide Inpatient Sample (NIS) files from 2000 to 2008 was performed. For the purposes of the study, gallbladder damage control was defined as PC, laparoscopic PC, and TC.A national estimate of 10,872 gallbladder damage control cases was obtained. Procedures performed included PC (47.8 %), laparoscopic PC (27.2 %), TC (25.3 %), and intraoperative cholangiogram (IOC) (19.7 %). A total of 1,479 (13.6 %) postoperative complications were identified, including pulmonary complications (4.3 %), hemorrhage/hematoma/seroma (3.4 %), and accidental puncture or laceration during procedure (3.3 %). Common bile duct injury occurred in 3.3 % overall. Hospital types included nonteaching (82.1 %) and urban (67.8 %), with regional variations of 42.1 % from the South and 45.2 % from the West. Inpatient outcomes included mean length of stay of 11.4 (0.16 SEM) days, mean total hospital charge of $71,296.69 ($1,106.03 SEM), 7.4 % mortality, and 16.8 % discharge to skilled nursing facility. Multivariate logistic regression analysis identified independent risk variables for common bile duct injury: teaching hospitals (OR = 1.517, CI = 1.155-1.991, P = 0.003). IOC (OR = 2.030, CI = 1.590-2.591, P < 0.001) was a commonly associated procedure in the setting of common bile duct injury.Various circumstances may require gallbladder damage control with PC and TC. Postoperative complications and common bile duct injury remain significantly high despite limited resection, and the teaching status of the hospital is associated with CBD injury. High morbidity and mortality of gallbladder damage control may reflect both the compromised nature of the procedures and multiple comorbidities.
机译：这项研究的目的是分析基于人群的数据库，以了解以下方面的信息：（1）部分胆囊切除术（PC），腹腔镜PC和套管针胆囊造口术（TC）的近期9年趋势，（2）人口统计学，相关诊断和医院特征以及（3）相关的住院结局。对2000年至2008年的全国住院样本（NIS）文件进行回顾性队列分析。为了研究的目的，将胆囊损害控制定义为PC，腹腔镜PC和TC。全国估计有10,872例胆囊损害控制病例。所执行的程序包括PC（47.8％），腹腔镜PC（27.2％），TC（25.3％）和术中胆道造影（IOC）（19.7％）。总共确定了1479例（13.6％）术后并发症，包括肺部并发症（4.3％），出血/血肿/血清肿（3.4％）以及手术过程中意外穿刺或撕裂（3.3％）。总胆管损伤发生率为3.3％。医院类型包括非教学型（82.1％）和城市型（67.8％），南部地区的差异为42.1％，西部地区的差异为45.2％。住院结局包括平均住院天数11.4（0.16 SEM）天，平均总住院费用为$ 71,296.69（$ 1,106.03 SEM），死亡率为7.4％，出勤率为16.8％。多元逻辑回归分析确定了胆总管损伤的独立风险变量：教学医院（OR = 1.517，CI = 1.155-1.991，P = 0.003）。 IOC（OR = 2.030，CI = 1.590-2.591，P <0.001）是常见的胆总管损伤相关手术。各种情况下可能需要通过PC和TC控制胆囊损伤。尽管切除范围有限，但术后并发症和胆总管损伤仍然很高，医院的教学状况与CBD损伤有关。胆囊损害控制的高发病率和高死亡率可能既反映了手术性质的损害，也反映了多种合并症。

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