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Beyond The Learning Curve: Incidence Of Bile Duct Injuries Following Laparoscopic Cholecystectomy Normalize To Open In The Modern Era

Caitlin A. Halbert, Spyridon Pagkratis, Jie Yang, Ziqi Meng, Maria S. Altieri, Purvi M. Parikh, Aurora Pryor, Mark A. Talamini, Dana A. Telem
Published 2015 · Medicine
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BackgroundEarly reports of higher complication rates, specifically bile duct injuries, raised concerns over the safety of laparoscopy over open cholecystectomy. This study aims to ascertain the rate, management, and perioperative outcomes of bile duct injury in an era beyond the laparoscopic learning curve.MethodsThe New York State (NYS) Planning and Research Cooperative System longitudinal administrative database was used to identify patients. From 2005 to 2010, 156,315 patients were identified who had undergone laparoscopic cholecystectomy for symptomatic cholelithiasis or acute or chronic cholecystitis. Patients were then tracked with unique identifiers for common bile duct injury. Common bile duct injury was identified by ICD-9 and CPT diagnosis and procedure codes for patients who subsequently underwent hepatectomy, hepaticojejunostomy, or other bile duct surgery.ResultsFrom 2005 to 2010, 156,958 patients were identified who had undergone laparoscopic cholecystectomy for symptomatic cholelithiasis or acute or chronic cholecystitis. Of the total patients, 149 patients underwent a biliary duct procedure within a year. Twenty-four of them were diagnosed with gallbladder cancer and excluded, leaving 125 for further analysis. The biliary injuries were identified at a rate of 0.080 %. Thirty-one of those patients (24.8 %) underwent hepatectomy, 40 patients (32.0 %) underwent hepaticoenterostomy, and 54 patients (43.2 %) underwent primary repair of the bile duct. Thirty-two (26 %) patients were repaired on the same day of their initial procedure. Of the remaining 93 patients, 38 (30 %) were repaired within 10 days, seven (6 %) repaired between 11 and 20 days, and 48 (38 %) patients over 21 days from injury.ConclusionIn NYS, the rate of bile duct injury has now decreased to 0.08 % and mirrors the historical figures quoted for open cholecystectomy. This improvement likely reflects increased experience, improved instrumentation, and movement beyond the “learning curve.”
This paper references
National Institutes of Health Consensus Development Conference Statement on Gallstones and Laparoscopic Cholecystectomy.
National Institutes of Health consensus development conference statement: Gallstones and laparoscopic cholecystectomy September 14-16, 1992 (Final draft October 30, 1992)
John L. Gollan (1993)
Iatrogenic bile duct injuries
Paulo Roberto Savassi-Rocha (2002)
Causes and Prevention of Laparoscopic Bile Duct Injuries: Analysis of 252 Cases From a Human Factors and Cognitive Psychology Perspective
Lawrence W. Way (2003)
Bile duct injury after laparoscopic cholecystectomy
Bruce V Macfadyen (1998)
[Bile duct injury during laparoscopic cholecystectomy].
Johan Frederik Lange (2007)
Bile duct injury during laparoscopic cholecystectomy.
Lawrence W. Way (1992)
The dramatic reality of biliary tract injury during laparoscopic cholecystectomy
J.-F. Gigot (1997)
The learning curve for laparoscopic cholecystectomy. The Southern Surgeons Club.
Moore Mj (1995)
Kawashti AS (2010) Major biliary complications in 2,714 cases of laparoscopic cholecystectomy without intraoperative cholangiography: a multicenter retrospective study
MA Hamad (2010)
The United States Experience
Hans A. Linde (1972)
Bile Duct Injury During Laparoscopic Cholecystectomy: Results of a National Survey
Steven B Archer (2001)
The learning curve for laparoscopic cholecystectomy
Michael J Moore (1995)
Bile duct injury during laparoscopic cholecystectomy: a prospective nationwide series.
Sven Adamsen (1997)
Iatrogenic Bile Duct Injuries in Kashmir Valley
Nisar A Chowdri (2010)
Bile duct injury after laparoscopic cholecystectomy. The United States experience.
Bruce V Macfadyen (1998)
Bile duct injuries during laparoscopic cholecystectomy: a 1994–2001 audit on 13,718 operations in the area of Rome
Paolo Gentileschi (2003)
Major biliary complications in 2,714 cases of laparoscopic cholecystectomy without intraoperative cholangiography: a multicenter retrospective study
Mostafa A. Hamad (2011)

This paper is referenced by
Complex bile duct injuries after laparoscopic cholecystectomy: a comparative outcomes analysis of patients treated in tertiary private and public health facilities in Cape Town, South Africa.
Jessica Lindemann (2019)
Liver Transplantation for the Treatment of Complicated Iatrogenic Biliary Injuries: A National Review from the UNOS Data Set
Catherine R. Garcia (2017)
Value of the Robotic Platform in a Complex Cholecystectomy : A Case Report
Safe laparoscopic subtotal cholecystectomy in the face of severe inflammation in the cystohepatic triangle: a retrospective review and proposed management strategy for the difficult gallbladder
Roderick H. Purzner (2019)
An Update on Iatrogenic Biliary Injuries: Identification, Classification, and Management.
Joshua T. Cohen (2019)
Bile duct injuries (BDI) in the advanced laparoscopic cholecystectomy era
Christopher W. Mangieri (2018)
Index acute cholecystectomy: what's the problem?
Garth H Poole (2018)
Intraoperatively malpositioned stent as a complication of common bile duct injury during laparoscopic cholecystectomy
Timur Özdemir (2019)
Adverse outcomes and short-term cost implications of bile duct injury during cholecystectomy
Stephen J O'Brien (2019)
Increasing bile duct injury and decreasing utilization of intraoperative cholangiogram and common bile duct exploration over 14 years: an analysis of outcomes in New York State
Maria S. Altieri (2017)
Transplantation hépatique pour plaie iatrogène des voies biliaires post-cholécystectomie : étude rétrospective multicentrique nationale française
Maxime Guieu (2018)
Stephen O’Brien1 · David Wei2 · Neal Bhutiani1 · Mohan K. Rao3 · Stephen S. Johnston2 · Anuprita Patkar4 · Gary C. Vitale1 · Robert C. G. Martin II1,5
O'brien (2019)
Comparison of Biliary Stent versus Biliary Sphincterotomy Alone in the Treatment of Bile Leak
Subhash Chandra (2019)
Subtotal laparoscopic cholecystectomy influences the rate of conversion in patients with difficult laparoscopic cholecystectomy: Case series
W.E. Abdelrahim (2017)
Cholecystectomy following percutaneous cholecystostomy tube placement leads to higher rate of CBD injuries
Maria S. Altieri (2018)
Long-Term Impact of Iatrogenic Bile Duct Injury
Anne Marthe Schreuder (2019)
Injury of the aberrant bile duct: beware of what you don't see.
John A. Dumot (2020)
Elimination of Bile Duct Injury in Cholecystectomy.
Maria S. Altieri (2019)
Comparing early and delayed repair of common bile duct injury to identify clinical drivers of outcome and morbidity.
Russell C. Kirks (2016)
Prospective Evaluation of Precision Multimodal Gallbladder Surgery Navigation: Virtual Reality, Near-infrared Fluorescence, and X-ray-based Intraoperative Cholangiography
M. Diana (2017)
A practical guide for the use of indocyanine green and methylene blue in fluorescence‐guided abdominal surgery
Labrinus van Manen (2018)
Laparoscopic ultrasonography as an alternative to intraoperative cholangiography during laparoscopic cholecystectomy
Alexandra Dili (2017)
Using laparoscopic ultrasound to delineate dangerous anatomy during difficult laparoscopic cholecystectomies.
Maciej Sebastian (2019)
Evaluation of the usefulness of the SAGES Safe Cholecystectomy Program from the viewpoint of the European surgeon
Paweł Bogacki (2020)
Direct Gallbladder Indocyanine Green Injection Fluorescence Cholangiography During Laparoscopic Cholecystectomy.
GravesClaire (2017)
The application of simulation-based medical education in low- and middle-income countries; the Myanmar experience.
Yin Mar Oo (2020)
Long-term outcomes of patients with common bile duct injury following laparoscopic cholecystectomy
Caitlin A. Halbert (2016)
The Best Approach for Laparoscopic Fluorescence Cholangiography: Overview of the Literature and Optimization of Dose and Dosing Time
Leonora S. F. Boogerd (2017)
Intraoperative Cholangiography (IOC): Important Aid in Biliary and Common Bile Duct Surgery
George Berci (2020)
Bile duct injuries: a contemporary survey of surgeon attitudes and experiences
Reid Fletcher (2019)
Post-cholecystectomy Bile Duct Injury
Matthew P. Lungren (2020)
Intraoperative detection of aberrant biliary anatomy via intraoperative cholangiography during laparoscopic cholecystectomy.
Marthe Chehade (2019)
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