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Inter-surgeon Variability in Cystic Artery Lymph Node Excision during Laparoscopic Cholecystectomy
Introduction Expert opinion recommends that surgeons perform a laparoscopic cholecystectomy (LC) in a standardized manner by dissecting the hepatobiliary triangle lateral to the cystic artery lymph node (LN) to minimize the rate of a major bile duct injury. Methods To determine whether surgeons perf...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6080738/ https://www.ncbi.nlm.nih.gov/pubmed/30094116 http://dx.doi.org/10.7759/cureus.2759 |
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author | Wysocki, Arkadiusz P Murphy, Skyle Baade, Ingrid |
author_facet | Wysocki, Arkadiusz P Murphy, Skyle Baade, Ingrid |
author_sort | Wysocki, Arkadiusz P |
collection | PubMed |
description | Introduction Expert opinion recommends that surgeons perform a laparoscopic cholecystectomy (LC) in a standardized manner by dissecting the hepatobiliary triangle lateral to the cystic artery lymph node (LN) to minimize the rate of a major bile duct injury. Methods To determine whether surgeons performed a laparoscopic cholecystectomy in a standardized manner, the study assessed the variability in the frequency of an LN excision. All LCs that were performed at a single hospital were identified from a prospective dataset. The presence of an LN was retrospectively determined from the histology report. Results Twenty-seven surgeons were recorded to have performed 2332 laparoscopic cholecystectomies. Out of the total number of patients, 76.8% were female. The median patient age was 42.4 years. About 60.8% of the LCs were elective, while 39.2% of them were acute. Nineteen pathologists reported that in 99% of the specimens – the LN status of 1831 (78.5%) gallbladders was reported and analyzed. Overall, the LN yield per surgeon varied from 0% to 50% (mean 18.7%). Conclusion The high inter-surgeon variability in the rate of LN excision during laparoscopic cholecystectomy shows that surgeons dissect the hepatobiliary triangle differently. The LN yield may also represent a surrogate marker of surgical technique (which is easy to measure). |
format | Online Article Text |
id | pubmed-6080738 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-60807382018-08-09 Inter-surgeon Variability in Cystic Artery Lymph Node Excision during Laparoscopic Cholecystectomy Wysocki, Arkadiusz P Murphy, Skyle Baade, Ingrid Cureus Pathology Introduction Expert opinion recommends that surgeons perform a laparoscopic cholecystectomy (LC) in a standardized manner by dissecting the hepatobiliary triangle lateral to the cystic artery lymph node (LN) to minimize the rate of a major bile duct injury. Methods To determine whether surgeons performed a laparoscopic cholecystectomy in a standardized manner, the study assessed the variability in the frequency of an LN excision. All LCs that were performed at a single hospital were identified from a prospective dataset. The presence of an LN was retrospectively determined from the histology report. Results Twenty-seven surgeons were recorded to have performed 2332 laparoscopic cholecystectomies. Out of the total number of patients, 76.8% were female. The median patient age was 42.4 years. About 60.8% of the LCs were elective, while 39.2% of them were acute. Nineteen pathologists reported that in 99% of the specimens – the LN status of 1831 (78.5%) gallbladders was reported and analyzed. Overall, the LN yield per surgeon varied from 0% to 50% (mean 18.7%). Conclusion The high inter-surgeon variability in the rate of LN excision during laparoscopic cholecystectomy shows that surgeons dissect the hepatobiliary triangle differently. The LN yield may also represent a surrogate marker of surgical technique (which is easy to measure). Cureus 2018-06-07 /pmc/articles/PMC6080738/ /pubmed/30094116 http://dx.doi.org/10.7759/cureus.2759 Text en Copyright © 2018, Wysocki et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Pathology Wysocki, Arkadiusz P Murphy, Skyle Baade, Ingrid Inter-surgeon Variability in Cystic Artery Lymph Node Excision during Laparoscopic Cholecystectomy |
title | Inter-surgeon Variability in Cystic Artery Lymph Node Excision during Laparoscopic Cholecystectomy |
title_full | Inter-surgeon Variability in Cystic Artery Lymph Node Excision during Laparoscopic Cholecystectomy |
title_fullStr | Inter-surgeon Variability in Cystic Artery Lymph Node Excision during Laparoscopic Cholecystectomy |
title_full_unstemmed | Inter-surgeon Variability in Cystic Artery Lymph Node Excision during Laparoscopic Cholecystectomy |
title_short | Inter-surgeon Variability in Cystic Artery Lymph Node Excision during Laparoscopic Cholecystectomy |
title_sort | inter-surgeon variability in cystic artery lymph node excision during laparoscopic cholecystectomy |
topic | Pathology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6080738/ https://www.ncbi.nlm.nih.gov/pubmed/30094116 http://dx.doi.org/10.7759/cureus.2759 |
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