Bile duct injuries (BDI) in the advanced laparoscopic cholecystectomy era

Surgical Endoscopy
Christopher W MangieriByron J Faler

Abstract

Laparoscopic cholecystectomy is the most commonly performed laparoscopic procedure. It is superior in nearly every regard compared to open cholecystectomies. The one significant aspect where the laparoscopic approach is inferior regards the association with bile duct injuries (BDI). The BDI rate with laparoscopic cholecystectomy is approximately 0.5%; nearly triple the rate compared to the open approach. We propose that 0.5% BDI rate with the laparoscopic approach is no longer accurate. The National Surgical Quality Improvement Program (NSQIP) registry was retrospectively reviewed. All laparoscopic cholecystectomies performed between 2012 and 2016 were extracted. A total of 217,774 cases meeting inclusion criteria were analyzed. The primary data points were the overall BDI incidence rate and time of diagnosis. BDI were identified by ICD-9 and ICD-10 codes. Secondary data points were variables associated with BDI. The BDI rate was 0.19%. 77% of cases were diagnosed after the index surgical admission. Intra-operative cholangiography (IOC) use was associated with a higher BDI rate and higher identification rate of a BDI intraoperatively (P value < 0.0001). Resident teaching cases were protective with a RR score of 0.56 (P value < ...Continue Reading

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Citations

Mar 8, 2019·World Journal of Gastrointestinal Surgery·Vishal Gupta, Gaurav Jain
Feb 21, 2019·Updates in Surgery·Davis A HartnettAlan H Daniels
Sep 6, 2020·World Journal of Surgery·Maciej SebastianJerzy Rudnicki
Nov 26, 2020·Annals of Hepato-biliary-pancreatic Surgery·Supriya SharmaVinay K Kapoor
May 20, 2021·Revista do Colégio Brasileiro de Cirurgiões·Jorge Henrique Bento DE SousaOscar Fernando Pavão Dos Santos
Jun 12, 2021·World Journal of Emergency Surgery : WJES·Nicola de'AngelisDaniele Sommacale
Aug 17, 2021·Annals of Surgery·Aaron B HoffmanKatia Noyes

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