Fluorescence cholangiography enhances surgical residents’ biliary delineation skill for laparoscopic cholecystectomies

• 作者: Narongsak Rungsakulkij Paramin Muangkaew Pongsatorn Tangtawee Siraprapa Thewmorakot Somkit Mingphruedhi Suraida Aeesoa Watoo Vassanasiri Wikran Suragul
• 来源期刊: 世界胃肠外科杂志:英文版(电子版)
• 学科: 医学
• 关键词: LAPAROSCOPIC CHOLECYSTECTOMY FLUORESCENCE CHOLANGIOGRAPHY RESIDENCY Education
• 年，卷（期）: 2020,（3）
• 页码范围: 93-103
• 页数: 11页
• 分类号: R65

摘要

BACKGROUND Laparoscopic cholecystectomy(LC)is a minimally invasive procedure,often performed by surgical residents(SRs).Fluorescence cholangiography(FC)enables real-time identification of biliary anatomy.AIM To investigate the benefit of FC for enhancing SRs’identification skills.METHODS Prospective data was collected from January 2018 to June 2018 at our hospital.The study cohorts were the SRs(study group,n=15)and the surgical staff(SS;control group,n=9).Participants were assigned to watch videos of LCs with FC from five different patients who had gallbladder disease,and identify structures in the video clips(including cystic duct,common bile duct,common hepatic duct,and cystic artery),first without FC,and then with FC.RESULTS In the without-FC phase,the overall misidentification rate by SRs(21.7%)was greater than that of the SS(11.8%;P=0.018),However,in the FC phase,the two groups did not significantly differ in misidentification rates(23.3%vs 23.3%,P=0.99).Paired-structure analysis of the without-FC and with-FC phases for the SR group found a significantly higher misidentification rate in the without-FC phase than the with-FC phase(21.9%vs 10.9%;P<0.01).However,misidentification rates in the with-FC phase did not significantly differ between SRs and SS.CONCLUSION FC enhanced identification skills of inexperienced surgeons during LC compared with conventional training.Combined with simulation-based video training,FC is a promising tool for enhancing technical and decision skills of trainees and inexperienced surgeons.