[评估 "Rendez-vous "技术与标准疗法在胆总管结石患者中的术后并发症]。

IF 0.5 4区 医学 Q4 SURGERY Cirugia Y Cirujanos Pub Date : 2023-05-11 DOI:10.24875/CIRU.21000192
Osvaldo C Barraza-Leones, Juan F Coronado-Sarmiento, Eduardo Valdivieso-Rueda, Óscar J Barrera-León, Enrique C Ramos-Clason
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引用次数: 0

摘要

背景:"Rendez-vous"(RV)技术是一种混合技术,同时使用腹腔镜和内镜技术;然而,在胆囊胆管炎的治疗中,该技术与两步顺序技术(内镜逆行胰胆管造影术[ERCP],然后腹腔镜胆囊切除术[LC])的实施情况存在矛盾:以两步顺序技术为比较对象,估计RV技术的实施与作为主要结果的术后并发症发生率之间的关系:方法:以诊断为胆石症、胆囊炎或轻度胆源性胰腺炎的患者病历为暴露队列,开展了一项观察性、分析性、回顾性研究。暴露人群接受了 RV 技术,而未暴露人群则接受了两步技术:结果:RV 组的术后并发症发生率(0%)低于对照组的 10.1%(P = 0.3617)。此外,RV 技术的住院时间更短(p = 0.0377),手术后住院时间更短(p < 0.0001):结论:RV 技术与两步顺序技术(ERCP 后进行 LC)相比,手术成功率更高,并发症发生率更低,住院时间更短,因此更有优势。
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[Evaluation of post-surgical complications between "Rendez-vous" technique vs. standard care in patients with choledocholithiasis].

Background: "Rendez-vous" (RV) technique is a mixed-technique which uses both laparoscopic and endoscopic skills; however, the evidence is contradictory regarding the implementation of this technique or the 2-step sequential technique (endoscopic retrograde cholangiopancreatography [ERCP] followed by laparoscopic cholecystectomy [LC]) in the management of cholecysto-choledocholitiasis.

Objective: To estimate the association between the implementation of RV technique and the presence of post-surgical complications as primary outcome, using as comparator the 2-step sequential technique.

Method: An observational, analytical, retrospective study was conducted, using as exposed cohort the medical records from patients with a diagnosis of cholelithiasis, cholecystitis, or mild biliary pancreatitis. The exposed cohort underwent RV technique, while the unexposed cohort were those which underwent two step technique.

Results: There was a lower post-surgical complication rate in the RV group (0%) compared with the 10.1% (p = 0.3617) in the control group. Also, RV technique showed a lesser hospitalization time (p = 0.0377) and a lesser post-surgical hospitalization time (p < 0.0001).

Conclusions: RV technique is superior when compared with the 2-step sequential technique (ERCP followed by LC), based on a better surgical success rate, a fewer complications rate and less hospitalization time.

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来源期刊
Cirugia Y Cirujanos
Cirugia Y Cirujanos 医学-外科
CiteScore
0.90
自引率
20.00%
发文量
207
审稿时长
6-12 weeks
期刊介绍: Cirugía y Cirujanoses exponente del desarrollo académico, científico, médico, quirúrgico y tecnológico en materia de salud en México y en el ámbito internacional. Es una revista bimestral, open access, revisada por pares, que publica en español y en inglés (traducido sin coste para los autores) artículos científicos originales, casos clínicos, artículos de revisión de interés general y cartas al editor. Los artículos se seleccionan y publican siguiendo un riguroso análisis, de acuerdo con los estándares internacionalmente aceptados. Sus espacios están abiertos a los académicos, así como a todo miembro de la comunidad médica que manifieste interés por utilizar este foro para publicar sus trabajos.
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