The effect of a simple simulator on the application of laparoscopic common bile duct exploration in a low volume center.

IF 1.3 Q3 Medicine Minerva chirurgica Pub Date : 2020-08-01 Epub Date: 2020-05-26 DOI:10.23736/S0026-4733.20.08243-7

Yongfeng Lv, Haiming Sun, Zhangxuan Qian, Weikun Mao, Weiyun Yao, Chencheng Ding, Zhiran Jin, Rui Li

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引用次数: 2

Abstract

Background: The purpose of this study was to investigate the effect of a simple laparoscopic common bile duct exploration (LCBDE) simulator and corresponding practicing program on the application of performing LCBDE in a low volume center.

Methods: A retrospective review was performed by analyzing data from the electronic medical record for 4118 patients with choledocholithiasis in Changxing County Hospital (Huzhou, Zhejiang, China) between January 2013 and December 2018. From January 2016, we have developed a simple LCBDE-specific simulator and corresponding practicing program in our hospital. The percentage of patients with choledocholithiasis managed by LCBDE before and after the introduction of a simple LCBDE-specific simulator and corresponding practicing program was compared.

Results: There were 8.9% (367/4118) patients with a diagnosis of choledocholithiasis confirmed by MRCP. Single-stage management with LC+LCBDE was performed in 23.7% (87/367) patients. Among them, 23 cases were performed between January 2013 and December 2015, and 64 cases were performed between January 2016 and December 2018. The introduction of simulator-enhanced practicing program in January 2016 has resulted in an increase in the percentage of performed LCBDE, from 12.9% to 33.9%. In addition, there was an 29.5% reduction in the mean operating time (from 193 min to 136 min) needed for LCBDE with T-tube when compared these two periods.

Conclusions: LCBDE simulator can improve the application in a low volume center, and help to increase the utilization of this effective, one stage treatment for choledocholithiasis and reduce the need for costlier ERCP.

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简易模拟器在小容积中心腹腔镜胆总管探查中的应用效果。

背景:本研究旨在探讨简易腹腔镜胆总管探查(LCBDE)模拟器及相应的练习程序在小容积中心实施LCBDE的应用效果。方法:回顾性分析2013年1月至2018年12月在中国浙江湖州长兴县医院就诊的4118例胆总管结石患者的电子病历数据。从2016年1月开始，我们在我院开发了简单的lcbde专用模拟器和相应的实习程序。比较引入简单的LCBDE专用模拟器及相应的实践程序前后LCBDE治疗胆总管结石患者的百分比。结果:有8.9%(367/4118)患者经MRCP确诊为胆总管结石。23.7%(87/367)患者采用LC+LCBDE单期治疗。其中2013年1月至2015年12月手术23例，2016年1月至2018年12月手术64例。2016年1月引入的模拟器增强练习项目使LCBDE的执行率从12.9%提高到33.9%。此外，与这两个时间段相比，t管LCBDE所需的平均操作时间(从193分钟减少到136分钟)减少了29.5%。结论:LCBDE模拟器可以提高在小容量中心的应用，有助于提高这种有效的一期治疗胆总管结石的利用率，减少对昂贵的ERCP的需求。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Minerva chirurgica 医学-外科

CiteScore

1.40

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Minerva Chirurgica publishes scientific papers on surgery. Manuscripts may be submitted in the form of editorials, original articles, review articles, case reports, special articles, letters to the Editor and guidelines. The journal aims to provide its readers with papers of the highest quality and impact through a process of careful peer review and editorial work.