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首页> 外文期刊>Surgical Endoscopy >A prospective study of ambulatory laparoscopic cholecystectomy: training economic, and patient benefits.
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A prospective study of ambulatory laparoscopic cholecystectomy: training economic, and patient benefits.

机译：动态腹腔镜胆囊切除术的前瞻性研究：培训经济和患者受益。

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BACKGROUND: Even though ambulatory laparoscopic cholecystectomy (ALC) is safe and cost effective, this approach has yet to gain acceptance in the United Kingdom. We report our 5-year experience of ALC with emphasis on its appropriateness for higher surgical training. METHODS: Between July 1997 and July 2002, patients with symptomatic cholelithiasis who met with appropriate criteria underwent ALC. Surgery was performed either by a consultant surgeon or a higher surgical trainee (HST) under direct supervision in our dedicated day surgery unit. Data were recorded prospectively and patients were interviewed postoperatively by an independent researcher. RESULTS: There were 269 patients (231 female and 38 male) with a median age of 46 years (range 17-76). Conversion to open cholecystectomy was necessary in three cases (1%). Of the patients, 79% (213) were discharged within 8 hours of surgery; 95% (256) were discharged on the same day. Thirteen patients (5%) required overnight admission as inpatients. An HST performed 166 (62%) of the procedures. There was a statistically significant difference in operating time between consultants (41 min) and trainees (47 min, P = 0.001) but no significant difference in clinical outcome or patient satisfaction. The mean procedural cost to the hospital was 768 pound sterling for ALC compared with 1430 pound sterling for an inpatient operation. Of patients, 87% expressed satisfaction with the day case operation. CONCLUSION: Our results for ALC compare favorably with published series. In addition, we have demonstrated that the operation can be performed safely by HST under direct supervision without compromising operating lists or safety.
机译：背景：尽管动态腹腔镜胆囊切除术（ALC）是安全且经济有效的，但这种方法尚未在英国获得认可。我们报告了ALC的5年经验，重点是其对更高级别外科手术培训的适用性。方法：1997年7月至2002年7月，对符合标准的有症状胆石症患者进行ALC。外科手术由顾问外科医生或高级外科实习生（HST）在我们专职的日间手术部门的直接监督下进行。前瞻性记录数据，术后由独立研究人员采访患者。结果：269例患者（231名女性和38名男性）的中位年龄为46岁（范围17-76）。 3例（1％）有必要改行开腹胆囊切除术。在这些患者中，有79％（213）在手术后8小时内出院。 95％（256）在同一天出院。十三名患者（5％）需要住院过夜。 HST执行了166（62％）个程序。顾问（41分钟）和受训者（47分钟，P = 0.001）之间的手术时间有统计学上的显着差异，但临床结果或患者满意度方面无显着差异。医院的平均手术费用为ALC为768英镑，而住院手术为1430英镑。 87％的患者对日间手术表示满意。结论：我们的ALC结果与已发表的系列比较好。此外，我们证明了HST可以在直接监督下安全地执行操作，而不会影响操作清单或安全性。

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