Background

Several guidelines have put forward recommendations about the perioperative process of cholecystectomy. Despite the recommendations, controversy remains concerning several topics, especially in low- and middle-income countries. The aim of this study was to develop uniform recommendations for perioperative practices in cholecystectomy in Mexico to standardize this process and save public health system resources.

Methods

A modified Delphi method was used. An expert panel of 23 surgeons anonymously completed two rounds of responses to a 29-item questionnaire with 110 possible answers. The consensus was assessed using the percentage of responders agreeing on each question.

Results

From the 29 questions, the study generated 27 recommendations based on 20 (69.0%) questions reaching consensus, one that was considered uncertain (3.4%), and six (20.7%) items that remained open questions. In two (6.9%) cases, no consensus was reached, and no recommendation could be made.

Conclusions

This study provides recommendations for the perioperative management of cholecystectomy in public hospitals in Mexico. As a guide for public institutions in low- and middle-income countries, the study identifies recommendations for perioperative tests and evaluations, perioperative decision making, postoperative interventions and institutional investment, that might ensure the safe practice of cholecystectomy and contribute to conserving resources.

中文翻译：

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就公立医院胆囊切除术的围手术期管理建立共识：与墨西哥专家小组进行的德尔福研究

背景

一些指南对胆囊切除术的围手术期提出了建议。尽管有这些建议，但在几个主题上仍存在争议，尤其是在低收入和中等收入国家。本研究的目的是为墨西哥胆囊切除术的围手术期实践制定统一的建议，以规范这一过程并节省公共卫生系统资源。

方法

使用了改进的 Delphi 方法。一个由 23 名外科医生组成的专家小组匿名完成了对包含 110 个可能答案的 29 项问卷的两轮回复。使用同意每个问题的响应者的百分比来评估共识。

结果

在 29 个问题中，该研究基于 20 个（69.0%）达成共识的问题、1 个被认为不确定的（3.4%）问题和 6 个（20.7%）仍然未解决的问题提出了 27 项建议。在两个（6.9%）的案例中，没有达成共识，也没有提出建议。

结论

本研究为墨西哥公立医院胆囊切除术的围手术期管理提供建议。作为低收入和中等收入国家公共机构的指南，该研究确定了围手术期检查和评估、围手术期决策、术后干预和机构投资的建议，以确保胆囊切除术的安全实践并有助于节约资源。