Gallbladder cancer (GBC) is the most common malignancy of the biliary system in clinic, which has the characteristics of insidious onset and high degree of malignancy. Most patients have progressed to an advanced stage when they are diagnosed. Early identification of risk factors of the onset of gallbladder cancer and active intervention are the key to improve the rate of early diagnosis and prognosis of gallbladder cancer. At present, the risk factors related to the onset of gallbladder cancer include gallstone, gallbladder polyps, primary sclerosing cholangitis, etc. In this review, we discuss the relevant latest research on the risk factors of the onset of gallbladder cancer in order to provide clinical evidence for the prevention and early diagnosis of gallbladder cancer. The intervention, follow-up, and monitoring of risk factors should be strengthened, and the possibility of malignancy of the gallbladder should be accurately assessed in combination with factors such as age and sex. In the case of possible malignancy, prophylactic cholecystectomy should be actively performed.
BACKGROUND
Operating surgeons can experience work-related physical and mental health impairments that may contribute to chronic muscle damage, burnout, and even withdrawal. However, camera-holder assistants in laparoscopic surgery may also experience similar issues, which are often ignored.
OBJECTIVE
We assessed the difference in physical and mental health impairments between operating surgeons and camera-holder assistants.
METHODS
A one-year survey of operating surgeons and camera-holder assistants evaluated the occurrence of muscle pain, fatigue, verbal scolding, and task load (i.e., mental, physical, perceptual, and anxiety) during laparoscopic surgery for benign diseases.
RESULTS
Among 2184 laparoscopic operations (69.16% of the total operations), 81% (operating surgeons) and 78% (camera-holder assistants) reported experiencing muscle pain/discomfort during the procedure. The anatomic regions were mainly concentrated in the shoulders and upper limbs (operating surgeons) and in the lower back and shoulders (camera-holder assistants). The VAS scores for operating surgeons and camera-holder assistants were 2.8 and 2.4, respectively, P<0.001. Additionally, 73.2% (operating surgeons) and 61% (camera-holder assistants) reported that muscle pain persisted postoperatively. Intraoperative fatigue was reported by 41.7% (operating surgeons) and 51.7% (camera-holder assistants). More than half (55.2%) of camera-holder assistants reported being verbally scolded by operating surgeons during the operation, and 64.6% of them believed that the scolding was mentally stressful. The reason for the scolding was mainly due to the poor coordination of laparoscope movement. After weighted scoring, the physical health impairment score of laparoscopic surgery for operating surgeons and camera-holder assistants was 2.7 vs. 1.6 (P<0.001), and the mental health impairment score was 3.4 vs. 3.2 (P<0.001).
CONCLUSIONS
The physical and mental health impairments experienced by camera-holder assistants during laparoscopic procedures, while less severe than those experienced by operating surgeons, should not be ignored.
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