Documenting correct assessment of biliary anatomy during laparoscopic cholecystectomy

被引:29
作者
Buddingh, K. T. [1 ]
Morks, A. N. [1 ]
Hoedemaker, H. O. ten Cate [1 ]
Blaauw, C. B. [2 ]
van Dam, G. M. [1 ]
Ploeg, R. J. [1 ]
Hofker, H. S. [1 ]
Nieuwenhuijs, V. B. [1 ]
机构
[1] Univ Med Ctr Groningen, Div Abdominal Surg, Dept Surg, NL-9700 RB Groningen, Netherlands
[2] Univ Groningen, Div Med Law, Fac Med Sci, Dept Med Humanities, Groningen, Netherlands
来源
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES | 2012年 / 26卷 / 01期
关键词
Bile duct injury; Cholecystectomy; Critical view of safety; Intraoperative cholangiography; BILE-DUCT INJURY; ROUTINE INTRAOPERATIVE CHOLANGIOGRAPHY; LITIGATION; COMPLICATIONS; MALPRACTICE; AGREEMENT;
D O I
10.1007/s00464-011-1831-x
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background Correct assessment of biliary anatomy can be documented by photographs showing the "critical view of safety" (CVS) but also by intraoperative cholangiography (IOC). Methods Photographs of the CVS and IOC images for 63 patients were presented to three expert observers in a random and blinded fashion. The observers answered questions pertaining to whether the biliary anatomy had been conclusively documented. Results The CVS photographs were judged to be "conclusive" in 27%, "probable" in 35%, and "inconclusive" in 38% of the cases. The IOC images performed better and were judged to be "conclusive" in 57%, "probable" in 25%, and "inconclusive" in 18% of the cases (P < 0.001 compared with the photographs). The observers indicated that they would feel comfortable transecting the cystic duct based on the CVS photographs in 52% of the cases and based on the IOC images in 73% of the cases (P = 0.004). The interobserver agreement was moderate for both methods (kappa values, 0.4-0.5). For patients with a history of cholecystitis, both the CVS photographs and the IOC images were less frequently judged to be sufficient for transection of the cystic duct (P = 0.006 and 0.017, respectively). Conclusion In this series, IOC was superior to photographs of the CVS for documentation of the biliary anatomy during laparoscopic cholecystectomy. However, both methods were judged to be conclusive only for a limited proportion of patients, especially in the case of cholecystitis. This study highlights that documenting assessment of the biliary anatomy is not as straightforward as it seems and that protocols are necessary, especially if the images may be used for medicolegal purposes. Documentation of the biliary anatomy should be addressed during training courses for laparoscopic surgery.
引用
收藏
页码:79 / 85
页数:7
相关论文
共 22 条
[1]   15 Years of Litigation Following Laparoscopic Cholecystectomy in England [J].
Alkhaffaf, Bilal ;
Decadt, Bart .
ANNALS OF SURGERY, 2010, 251 (04) :682-685
[2]  
Buddingh KT, 2011, WORLD J SURG, V35, P1235, DOI 10.1007/s00268-011-1061-3
[3]   Intraoperative assessment of biliary anatomy for prevention of bile duct injury: a review of current and future patient safety interventions [J].
Buddingh, K. Tim ;
Nieuwenhuijs, Vincent B. ;
van Buuren, Lianne ;
Hulscher, Jan B. F. ;
de Jong, Johannes S. ;
van Dam, Gooitzen M. .
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2011, 25 (08) :2449-2461
[4]  
BUDDINGH KT, 2011, J AM COLL SURG
[5]   Litigious Consequences of Open and Laparoscopic Biliary Surgical Mishaps [J].
Chandler J.G. ;
Voyles C.R. ;
Floore T.L. ;
Bartholomew L.A. .
Journal of Gastrointestinal Surgery, 1997, 1 (2) :138-145
[6]   Poor Agreement Among Expert Witnesses in Bile Duct Injury Malpractice Litigation An Expert Panel Survey [J].
de Reuver, Philip R. ;
Dijkgraaf, Marcel G. W. ;
Gevers, Sjef K. M. ;
Gouma, Dirk J. .
ANNALS OF SURGERY, 2008, 248 (05) :815-820
[7]   Litigation after laparoscopic cholecystectomy: An evaluation of the dutch arbitration system for medical malpractice [J].
de Reuver, Philip R. ;
Wind, Jan ;
Cremers, Jan E. ;
Busch, Olivier R. ;
van Gulik, Thomas M. ;
Gouma, Dirk J. .
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2008, 206 (02) :328-334
[8]   Registering the critical view of safety: photo or video? [J].
Emous, M. ;
Westerterp, M. ;
Wind, J. ;
Eerenberg, J. P. ;
van Geloven, A. A. W. .
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2010, 24 (10) :2527-2530
[9]   Complications of cholecystectomy: Risks of the laparoscopic approach and protective effects of operative cholangiography - A population-based study [J].
Fletcher, DR ;
Hobbs, MST ;
Tan, P ;
Valinsky, LJ ;
Hockey, RL ;
Pikora, TJ ;
Knuiman, MW ;
Sheiner, HJ ;
Edis, A .
ANNALS OF SURGERY, 1999, 229 (04) :449-457
[10]   Intraoperative cholangiography and risk of common bile duct injury during cholecystectomy [J].
Flum, DR ;
Dellinger, EP ;
Cheadle, A ;
Chan, L ;
Koepsell, T .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2003, 289 (13) :1639-1644