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Bile duct injuries during laparoscopic cholecystectomy: a 1994–2001 audit on 13,718 operations in the area of Rome

  • P. Gentileschi
  • M. Di Paola
  • M. Catarci
  • E. Santoro
  • L. Montemurro
  • M. Carlini
  • E. Nanni
  • L. Alessandroni
  • R. Angeloni
  • B. Benini
  • F. Cristini
  • A. Dalla Torre
  • C. De Stefano
  • A. Gatto
  • F. Gossetti
  • S. Manfroni
  • P. Mascagni
  • L. Masoni
  • G. Montalto
  • D. Polito
  • E. Puce
  • G. Silecchia
  • A. Terenzi
  • M. Valle
  • S. Vita
  • T. Zanarini
Original article

Abstract

Background

Bile duct injuries (BDIs) during laparoscopic cholecystectomy (LC) still are reported with greater frequency than during open cholecystectomy (OC).

Methods

In 1999, a retrospective study evaluating the incidence of BDIs during LC in the area of Rome from 1994 to 1998 (group A) was performed. In addition, a prospective audit was started, ending in December 2001 (group B).

Results

In group A, 6,419 LCs were performed (222 were converted to OC; 3.4%). In group B, 7,299 LCs were performed (225 were converted to OC; 3.1%). Seventeen BDIs (0.26%) occurred in group A and 16 (0.22%) in group B. Overall, mortality and major morbidity rates were 12.1% and 30.3%, respectively, without significant differences between the two groups.

Conclusions

The incidence and clinical relevance of BDIs during LC in the area of Rome appeared to be stable over the past 8 years and were not influenced by the use of a prospective audit, as compared with a retrospective survey.

Keywords

Cholecystectomy Laparoscopic/adverse effects Bile duct/injuries Multicenter studies 

References

  1. 1.
    Archer, SB, Brown, DW, Smith, D, Branum, GD, Hunter, JG 2001Bile duct injury during laparoscopic cholecystectomy: results of a national survey.Ann Surg234549559CrossRefPubMedGoogle Scholar
  2. 2.
    Buell, JF, Cronin, DC, Funaki, B, Koffron, A, Yoshida, A, Lo, A, Leef, J, Millis, JM 2002Devastating and fatal complications associated with combined vascular and bile duct injuries during cholecystectomy.Arch Surg137703708CrossRefPubMedGoogle Scholar
  3. 3.
    Calvete, J, Sabeter, L, Camps, B, Verdu, A, Gomez-Portilla, A, Martin, J, Torrico, MA, Flor, B, Cassinello, N, Liedo, S 2000Bile duct injury during laparoscopic cholecystectomy: myth or reality of the learning curve?Surg Endosc14605611CrossRefPubMedGoogle Scholar
  4. 4.
    Catarci, M, Carlini, M, Gentileschi, P, Santoro, E 2001Major and minor injuries during the creation of pneumoperitoneum: a multicenter study on 12,919 cases.Surg Endosc15566569CrossRefPubMedGoogle Scholar
  5. 5.
    Davidoff, AM, Pappas, TN, Murray, EA, Hilleren, DJ, Johnson, RD, Baker, ME, Newman, GE, Cotton, PB, Meyers, WC 1992Mechanisms of major biliary injury during laparoscopic cholecystectomy.Ann Surg215196202PubMedGoogle Scholar
  6. 6.
    Jarnagin, WR, Blumgart, LH 1999Operative repair of bile duct injuries involving the hepatic duct confluence.Arch Surg134769775CrossRefPubMedGoogle Scholar
  7. 7.
    Jones Monahan, K, Gruenberg, JC 1998Bile duct injuries during laparoscopic cholecystectomy: a community’s experience.Am Surg64638642PubMedGoogle Scholar
  8. 8.
    Krahenbuhl, L, Sclabas, G, Wente, N, Schafer, M, Schlumpf, R, Buchler, MW 2001Incidence, risk factors, and prevention of biliary tract injuries during laparoscopic cholecystectomy in Switzerland.World J Surg2513251330PubMedGoogle Scholar
  9. 9.
    Ludwig, K, Bernhardt, J, Steffen, H, Lorenz, D 2002Contribution of intraoperative cholangiography to incidence and outcome of common bile duct injuries during laparoscopic cholecystectomy.Surg Endosc1610981104CrossRefPubMedGoogle Scholar
  10. 10.
    MacFadyen, BV,Jr, Vecchio, R, Ricardo, E, Mathis, CR 1998Bile duct injury after laparoscopic cholecystectomy: the United States experience.Surg Endosc12315321CrossRefPubMedGoogle Scholar
  11. 11.
    McMahon, AJ, Fischbacher, CM, Frame, SH, MacLeod, MC 2000Impact of laparoscopic cholecystectomy: a population-based study.Lancet35616321637CrossRefPubMedGoogle Scholar
  12. 12.
    McMahon, AJ, Fullarton, G, Baxter, JN, O’Dwyer, PJ 1995Bile duct injury and bile leakage in laparoscopic cholecystectomy.Br J Surg82307313PubMedGoogle Scholar
  13. 13.
    Moody, F 2000Bile duct injury during laparoscopic cholecystectomy.Surg Endosc14605607CrossRefPubMedGoogle Scholar
  14. 14.
    Moosa, AR, Easter, DW, Sonnenberg, E, Casola, G, D’Agostino, H 1992Laparoscopic injuries to the bile duct: a cause for concern.Ann Surg215203208PubMedGoogle Scholar
  15. 15.
    Murr, MM, Gigot, JF, Nagorney, DM, Harmsen, WS, Ilstrup, DM, Farnell, MB 1999Long-term results of biliary reconstruction after laparoscopic bile duct injuries.Arch Surg134604610CrossRefPubMedGoogle Scholar
  16. 16.
    Nordin, A, Halme, L, Makisalo, H, Isoniemi, H, Hockerstedt, K 2002Management and outcome of major bile duct injuries after laparoscopic cholecystectomy: from therapeutic endoscopy to liver transplantation.Liver Transplant810361043CrossRefGoogle Scholar
  17. 17.
    Regoly-Merei, J, Ihasz, M, Szerberin, Z, Sandor, J, Matè, M 1998Biliary tract complications in laparoscopic cholecystectomy: a multicenter study of 148 biliary tract injuries in 26,440 operations.Surg Endosc12294300CrossRefPubMedGoogle Scholar
  18. 18.
    Richardson, MC, Bell, G, Fullarton, GM 1996Incidence and nature of bile duct injuries following laparoscopic cholecystectomy: an audit of 5,913 cases.Br J Surg8313561360Google Scholar
  19. 19.
    Roy, AF, Passi, RB, Lapointe, RW, McAlister, VC, Dagenais, MH, Wall, WJ 1993Bile duct injury during laparoscopic cholecystectomy.Can J Surg36509516PubMedGoogle Scholar
  20. 20.
    Russell, JC, Walsch, SJ, Mattie, AS, Lynch, JT 1996Bile duct injuries, 1989–1993: a statewide experience. Connecticut Laparoscopic Cholecystectomy Registry.Arch Surg131382388PubMedGoogle Scholar
  21. 21.
    Shea, JA, Berlin, JA, Bachwich, DR, Staroscik, RN, Malet, PF, McGuckin, M, Schwartz, JS, Escarce, JJ 1998Indications for and outcomes of cholecystectomy: a comparison of the pre- and postlaparoscopic eras.Ann Surg227343350CrossRefPubMedGoogle Scholar
  22. 22.
    Shea, JA, Healey, MJ, Berlin, JA, Clarke, JR, Malet, PF, Staroscik, RN, Schwartz, JS, Williams, SV 1996Mortality and complications associated with laparoscopic cholecystectomy: a meta-analysis.Ann Surg224609620CrossRefPubMedGoogle Scholar
  23. 23.
    Strasberg, SM, Hertl, M, Soper, NJ 1995An analysis of the problem of biliary injury during laparoscopic cholecystectomy.J Am Coll Surg180101125PubMedGoogle Scholar
  24. 24.
    Taylor, B 1998Common bile duct injury during laparoscopic cholecystectomy in Ontario: does ICD-9 coding indicate true incidence?CMAJ158481485PubMedGoogle Scholar
  25. 25.
    Thompson, MH, Benger, JR 2000Cholecystectomy, conversion, and complications.HPB Surg11373378PubMedGoogle Scholar
  26. 26.
    Windsor, JA, Pong, J 1998Laparoscopic biliary injury: more than a learning curve problem.ANZ J Surg68186189Google Scholar
  27. 27.
    Zacks, SL, Sandler, RS, Rutledge, R, Brown, RS,Jr 2002A population-based cohort study comparing laparoscopic cholecystectomy and open cholecystectomy.Am J Gastroenterol97334340CrossRefPubMedGoogle Scholar
  28. 28.
    Z’graggen, K, Wehrli, H, Metzger, A, Buehler, M, Frei, E, Klaiber, C 1998Complications of laparoscopic cholecystectomy in Switzerland: a prospective 3-year study of 10,174 patients. Swiss Association of Laparoscopic and Thoracoscopic Surgery.Surg Endosc1213031310CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • P. Gentileschi
    • 1
    • 2
  • M. Di Paola
    • 1
  • M. Catarci
    • 1
  • E. Santoro
    • 1
  • L. Montemurro
    • 1
  • M. Carlini
    • 1
  • E. Nanni
    • 1
  • L. Alessandroni
    • 1
  • R. Angeloni
    • 1
  • B. Benini
    • 1
  • F. Cristini
    • 1
  • A. Dalla Torre
    • 1
  • C. De Stefano
    • 1
  • A. Gatto
    • 1
  • F. Gossetti
    • 1
  • S. Manfroni
    • 1
  • P. Mascagni
    • 1
  • L. Masoni
    • 1
  • G. Montalto
    • 1
  • D. Polito
    • 1
  • E. Puce
    • 1
  • G. Silecchia
    • 1
  • A. Terenzi
    • 1
  • M. Valle
    • 1
  • S. Vita
    • 1
  • T. Zanarini
    • 1
  1. 1.Lap Group RomaGruppo Laparoscopico RomanoRomaItaly
  2. 2.Via Antonio BosioRomaItaly

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