Safe cholecystectomy multi-society practice guideline and state-of-the-art consensus conference on prevention of bile duct injury during cholecystectomy.
Bile duct injury
Cholecystectomy
Gallstones
Laparoscopic cholecystectomy
Patient safety
Journal
Surgical endoscopy
ISSN: 1432-2218
Titre abrégé: Surg Endosc
Pays: Germany
ID NLM: 8806653
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
19
12
2019
accepted:
10
04
2020
pubmed:
14
5
2020
medline:
16
6
2021
entrez:
14
5
2020
Statut:
ppublish
Résumé
Bile duct injury (BDI) is the most common serious complication of laparoscopic cholecystectomy. To address this problem, a multi-society consensus conference was held to develop evidenced-based recommendations for safe cholecystectomy and prevention of BDI. Literature reviews were conducted for 18 key questions across six broad topics around cholecystectomy directed by a steering group and subject experts from five surgical societies (SAGES, AHPBA IHPBA, SSAT, and EAES). Evidence-based recommendations were formulated using the GRADE methodology. When evidence-based recommendations could not be made, expert opinion was documented. A number of recommendations for future research were also documented. Recommendations were presented at a consensus meeting in October 2018 and were voted on by an international panel of 25 experts with greater than 80% agreement considered consensus. Consensus was reached on 17 of 18 questions by the Guideline Development Group (GDG) and expert panel with high concordance from audience participation. Most recommendations were conditional due to low certainty of evidence. Strong recommendations were made for (1) use of intraoperative biliary imaging for uncertainty of anatomy or suspicion of biliary injury; and (2) referral of patients with confirmed or suspected BDI to an experienced surgeon/multispecialty hepatobiliary team. These consensus recommendations should provide guidance to surgeons, training programs, hospitals, and professional societies for strategies that have the potential to reduce BDIs and positively impact patient outcomes. Development of clinical and educational research initiatives based on these recommendations may drive further improvement in the quality of surgical care for patients undergoing cholecystectomy.
Sections du résumé
BACKGROUND
Bile duct injury (BDI) is the most common serious complication of laparoscopic cholecystectomy. To address this problem, a multi-society consensus conference was held to develop evidenced-based recommendations for safe cholecystectomy and prevention of BDI.
METHODS
Literature reviews were conducted for 18 key questions across six broad topics around cholecystectomy directed by a steering group and subject experts from five surgical societies (SAGES, AHPBA IHPBA, SSAT, and EAES). Evidence-based recommendations were formulated using the GRADE methodology. When evidence-based recommendations could not be made, expert opinion was documented. A number of recommendations for future research were also documented. Recommendations were presented at a consensus meeting in October 2018 and were voted on by an international panel of 25 experts with greater than 80% agreement considered consensus.
RESULTS
Consensus was reached on 17 of 18 questions by the Guideline Development Group (GDG) and expert panel with high concordance from audience participation. Most recommendations were conditional due to low certainty of evidence. Strong recommendations were made for (1) use of intraoperative biliary imaging for uncertainty of anatomy or suspicion of biliary injury; and (2) referral of patients with confirmed or suspected BDI to an experienced surgeon/multispecialty hepatobiliary team.
CONCLUSION
These consensus recommendations should provide guidance to surgeons, training programs, hospitals, and professional societies for strategies that have the potential to reduce BDIs and positively impact patient outcomes. Development of clinical and educational research initiatives based on these recommendations may drive further improvement in the quality of surgical care for patients undergoing cholecystectomy.
Identifiants
pubmed: 32399938
doi: 10.1007/s00464-020-07568-7
pii: 10.1007/s00464-020-07568-7
doi:
Types de publication
Consensus Development Conference
Journal Article
Practice Guideline
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2827-2855Subventions
Organisme : NIDDK NIH HHS
ID : R13 DK120271
Pays : United States
Investigateurs
Domenech Asbun
(D)
Chantel den Baaker
(C)
Luigi Boni
(L)
Ryan Campagna
(R)
Eugene Ceppa
(E)
Marie Crandall
(M)
Chris Davis
(C)
Shanley Deal
(S)
Scott Dojels
(S)
Ismael Domiguez-Rosado
(I)
Leonie van Gastel
(L)
Justin Gerard
(J)
Daniel Hashimoto
(D)
Ewen Harrison
(E)
Sara Holden
(S)
Romeo Ignacio
(R)
Oscara Imventarz
(O)
Rohan Jeyarajah
(R)
MacKenzie Landin
(M)
Charles Lawrence
(C)
Marc Mesleh
(M)
Sara Monafred
(S)
Alessandro Paganini
(A)
B Fernando Santos
(B)
Sadiq Sikora
(S)
Tim Schaffner
(T)
Nate Stoikes
(N)
Bailey Su
(B)
Megan Thomas
(M)
Ben Veenstra
(B)
Waala Abdelmoaty
(W)
Eline Zwart
(E)
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