Recommendation for Photographic Documentation of Safe Laparoscopic Cholecystectomy
- PDF / 713,963 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 44 Downloads / 189 Views
ORIGINAL SCIENTIFIC REPORT
Recommendation for Photographic Documentation of Safe Laparoscopic Cholecystectomy Maciej Sebastian1
•
Agata Sebastian2 • Jerzy Rudnicki1
Accepted: 23 August 2020 Ó The Author(s) 2020
Abstract Background Bile duct injury and vasculobiliary injury are possible complications during laparoscopic cholecystectomy which can lead to increased morbidity, mortality, costs of hospitalization and litigation. Proper documentation of the critical view of safety and safe plane of dissection may play a crucial role for archivization, teaching and medicolegal purposes. Methods The study group consisted of 100 patients with symptomatic cholecystolithiasis qualified for laparoscopic cholecystectomy. The critical view of safety was documented on two photographs and safe plain of dissection obtained with laparoscopic ultrasound was documented on one photograph as well as the whole procedure was recorded. The photographs were printed in the operating theatre and videos were stored on an external hard drive. Results The mean time to obtain and analyse photographs was significantly shorter than video, and the size of the stored data was significantly smaller for photographs than videos. The cost of one documentation procedure was significantly lower for video than photographs. Critical view of safety was obtained in 91 patients, and laparoscopic ultrasound was successful in 99 patients. The conversion rate was 2%, and fundus-first cholecystectomies were performed in 6% of patients. We did not observe any biliary and vascular complications. Conclusions Photographic documentation of the critical view of safety and safe plane of dissection should be an inherent part of laparoscopic cholecystectomy. Our proposal of documentation prepared in the operating theatre and stored in the patient’s documentation is an example of an easy, fast and cheap method of data archivization.
Introduction Laparoscopic cholecystectomy (LC) is nowadays the gold standard in the treatment of gallstone disease [1, 2]. The most dreaded complication of cholecystectomy is a bile
& Maciej Sebastian [email protected] 1
Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, Wrocław, Poland
2
Department of Rheumatology and Internal Medicine, Wroclaw Medical University, Borowska Street 213, Wrocław, Poland
duct injury (BDI) which rate has improved since introduction of LC from 1–1.5% to 0.08–0.3% reported recently what may be associated with increased experience, number of LCs performed beyond the ‘‘learning curve’’ and better instrumentation [3–7]. The critical view of safety (CVS) is a generally accepted method to identify the cystic duct and cystic artery during LC [8]. Laparoscopic ultrasound (LUS) along with intraoperative cholangiography (IOC) is adjunct method of intraoperative visualization especially in doubtful cases [9]. LUS is non-invasive and non-irradiating, visualize vascular structures and may be repeated as many times as it is needed what makes this method more safe a
