加速康复理念在梗阻性黄疸规范治疗中应用的专家共识
Expert consensus on enhanced recovery concept for the application of standardized management on obstructive jaundice
摘要因胆道系统特殊的解剖学特点及复杂的病理生理学过程,梗阻性黄疸具有治疗棘手、并发症多、恢复慢和住院时间长等特点。加速康复外科的核心——加速康复理念应用于梗阻性黄疸的治疗,可达到减轻应激反应、早期干预、减少并发症、缩短住院时间、降低再入院风险及降低医疗费用的目的;其核心理念为尽早解除梗阻、恢复胆道连续性及胆汁的肠肝循环,加速肝功能及受损器官功能的恢复,降低术后并发症发生率。鉴于此,中华医学会外科学分会胆道外科学组、白求恩公益基金会肝胆专委会、中华外科杂志编辑部组织相关专家,共同制订了本共识。本共识包括总则、梗阻性黄疸的术前胆汁引流、梗阻性黄疸相关疾病的治疗等17条推荐意见,旨在为加速康复理念在我国梗阻性黄疸治疗中的规范化、标准化应用提供参考。
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abstractsObstructive jaundice is characterized by complex management,more complications,slow recovery and long hospital stay due to special anatomy of the biliary tract system and the complicated pathophysiological changes.Enhanced recovery concept,which is the core of enhanced recovery after surgery,can be applied to the treatment of obstructive jaundice,which can alleviate stress responses,intervene early,reduce complications,shorten the length of hospital stay,reduce risk of readmission and average medical costs,its core concept consists in early removal of obstruction,recovering continuity of the biliary tract,normalizing the enterohepatic circulation of bile,accelerating the recovery of the liver and other organs′ function,and reducing postoperative complications.Based on this,Study Group of Biliary Tract Surgery in Chinese Society of Surgery of Chinese Medical Association,Hepatobiliary Committee of Bethune Charitable Foundation and Editorial Board of Chinese Journal of Surgery organized experts to make this consensus jointly. The consensus includes 17 recommendations about general contents,preoperative biliary drainage of obstructive jaundice and treatment of diseases related to obstructive jaundice.The consensus aims to provide a reference to the standardization and normalization of ERC in the treatment of obstructive jaundice in China.
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