日间病例腹腔镜胆囊切除术治疗胆囊疾病:文献综述。

IF 2.1 3区 医学 Q2 SURGERY Langenbeck's Archives of Surgery Pub Date : 2024-09-28 DOI:10.1007/s00423-024-03479-6
Mohamed Abuahmed, Rahel Rashid
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引用次数: 0

摘要

背景:日间病例腹腔镜胆囊切除术(DCLC)具有缩短住院时间、降低成本和改善患者体验等优点,已在全球范围内得到推广。尽管对患者安全的担忧,特别是与出血和胆管损伤有关的担忧依然存在,但文献支持腹腔镜胆囊切除术的疗效和优势,强调有必要在医疗机构中更广泛地采用腹腔镜胆囊切除术,以优化资源和改善患者预后:这是一项文献综述,旨在评估日间病例腹腔镜胆囊切除术治疗无症状胆结石患者的可行性和安全性,重点关注意外入院和再入院的发生率和病因,以及转开腹率。在PubMed上搜索了2014年至2024年间所有关于DCLC的研究。选择这一时间段是为了确定这一不断发展的领域的最新趋势和实践。通过关注这一特定时期,该综述旨在全面分析该领域的当前实践、新兴趋势和不断发展的护理标准:本综述强调,DCLC 术后意外入院的主要原因是术后恶心、呕吐和疼痛,而麻醉路径的实施明显增加了日间病例率。针对术后并发症发生率的研究一致发现,日间手术和住院手术之间没有显著差异:结论:对有症状的胆结石患者进行DCLC治疗安全有效,成功率高,患者满意度高,这一点得到了研究的支持。研究表明,DCLC 的并发症极少,再入院率也在可接受范围内,这表明 DCLC 可以成为选择性患者的标准方法,从而提高治疗效果和医疗效率。
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Day-case laparoscopic cholecystectomy in the management of gallbladder disease: a literature review.

Background: Day-case laparoscopic cholecystectomy (DCLC) has gained traction globally due to its benefits, including shorter hospital stays, reduced costs, and enhanced patient experience. While concerns about patient safety, particularly related to bleeding and bile duct injury persist, the literature supports the efficacy and advantages of DCLC highlighting the need for its wider adoption in healthcare settings to optimise resources and improve patient outcomes.

Methods: This was a literature review that aims to assess the feasibility and safety of day-case laparoscopic cholecystectomy for symptomatic gallstone patients, focusing on incidence and aetiology of unexpected admissions and readmissions, as well as conversion-to-open rates. PubMed was searched for all studies focusing on DCLC between 2014 and 2024. The timeframe was specifically selected to identify recent trends and practices in this evolving field. By focusing on this specific period, the review aims to provide a comprehensive analysis of current practices, emerging trends, and the evolving standard of care in this area.

Results: This review highlights that the main causes of unexpected admission post DCLC were postoperative nausea, vomiting, and pain, while the implementation of anaesthetic pathways notably increased day-case rates. Studies addressing complication rates postoperatively consistently found no significant difference between day-case and in-patient procedures.

Conclusions: DCLC for symptomatic gallstone patients is supported by research as safe and effective, with high success rates and patient satisfaction. Studies show minimal complications and acceptable readmission rates, suggesting that DCLC can be the standard approach for selective patients, improving outcomes and healthcare efficiency.

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来源期刊
CiteScore
3.30
自引率
8.70%
发文量
342
审稿时长
4-8 weeks
期刊介绍: Langenbeck''s Archives of Surgery aims to publish the best results in the field of clinical surgery and basic surgical research. The main focus is on providing the highest level of clinical research and clinically relevant basic research. The journal, published exclusively in English, will provide an international discussion forum for the controlled results of clinical surgery. The majority of published contributions will be original articles reporting on clinical data from general and visceral surgery, while endocrine surgery will also be covered. Papers on basic surgical principles from the fields of traumatology, vascular and thoracic surgery are also welcome. Evidence-based medicine is an important criterion for the acceptance of papers.
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