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

We propose that 0.5% bile duct injuries rate with the laparoscopic approach is no longer accurate

Christopher W. Mangieri

2018

Scholarcy highlights

  • Laparoscopic cholecystectomy is the most commonly performed laparoscopic procedure
  • The bile duct injuries rate with laparoscopic cholecystectomy is approximately 0.5%; nearly triple the rate compared to the open approach
  • The BDI rate was 0.19%. 77% of cases were diagnosed after the index surgical admission
  • The performance of laparoscopic cholecystectomies in North America is no longer associated with higher BDI rates compared to open
  • IOC use still is not protective against BDI, and cholecystitis continues to be a risk factor for BDI
  • When a cholecystectomy requires conversion from a laparoscopic to an open approach the BDI increases a hundredfold; which may raise the concern if this approach is still a safe bailout method for a difficult laparoscopic dissection
  • Eisenhower Army Medical Center, is a participant member of the American College of Surgeons National Surgical Quality Improvement Program and is authorized by the ACS to scientifically research and publish NSQIP data

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