Skip to main content

Advertisement

SpringerLink
Log in

Ten-year trend in the national volume of bile duct injuries requiring operative repair

  • Original article
  • Published:
Surgical Endoscopy And Other Interventional Techniques Aims and scope Submit manuscript

Abstract

Background

The objectives of this study were to determine the national proportions and mortality rate for bile duct injuries resulting from laparoscopic cholecystectomy (LC) that required operative reconstruction for repair over a 10-year period and to investigate the major factors associated with the mortality rate in this group of patients.

Methods

Using the Nationwide Inpatient Sample (NIS) of >7 million patient records per year, we extracted and analyzed data for LC during the years 1990–2000. Procedures that involved biliary reconstructions performed as part of another primary procedure were excluded. Using the Statistical Package for the Social Sciences (SPSS), we used procedure-specific codes that enabled us to calculate national estimates for LC for the time period under review. We then calculated biliary reconstruction procedures that occurred after LC for this cohort of patients. Finally, we analyzed in-hospital mortality, as well as the patient, institutional, and outcome characteristics associated with biliary reconstructions.

Results

The percentage of cholecystectomies performed laparoscopically has increased over the years for which data are available (from 52% in 1991 to 75% in 2000). Despite this increase, the mortality rate for this group of patients has remained consistently low over the study period (mean, 0.45%; range 0.33–0.58%). Within this group of patients, the average rate of bile duct injuries requiring operative repair was 0.15% for the years under study. The reconstruction rates ranged from 0.25% in 1992 to 0.09% in 1999. For 2000, the most recent year for which data are available, biliary reconstruction was performed in 0.10% of all patients who underwent LC. The average mortality rate for patients undergoing biliary reconstruction for the years 1991 to 2000 was 4.5%. After multivariate analysis, age, African American ethnicity, type of admission, source of admission, and hospital location, and teaching status were all found to correlate significantly with death after-biliary reconstruction.

Conclusions

These data show an increase in the percentage of cholecystectomies performed laparoscopically over the years under study and an associated low mortality rate. In contrast, although the number of bile duct injuries appears to be decreasing, these procedures continue to be associated with a significant mortality rate.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Figure 1
Figure 2

Similar content being viewed by others

References

  1. S Adamsen OH Hansen P Funch-Jensen S Schulze JG Stage P Wara (1997) ArticleTitleBile duct injury during laparoscopic cholecystectomy: a prospective nationwide series J Am Coll Surg 184 571–578 Occurrence Handle9179112

    PubMed  Google Scholar 

  2. SB Archer DW Brown CD Smith GD Branum JG Hunter (2001) ArticleTitleBile duct injury during laparoscopic cholecystectomy: results of a national survey Ann Surg 234 549–558 Occurrence Handle10.1097/00000658-200110000-00014 Occurrence Handle11573048

    Article  PubMed  Google Scholar 

  3. D Boerma EA Rauws YC Keulemans JJ Bergman H Obertop K Huibregtse DJ Gouma (2001) ArticleTitleImpaired quality of life 5 years after bile duct injury during laparoscopic cholecystectomy: a prospective analysis Ann Surg 234 750–757 Occurrence Handle10.1097/00000658-200112000-00006 Occurrence Handle11729381

    Article  PubMed  Google Scholar 

  4. BJ Carroll M Birth EH Phillips (1998) ArticleTitleCommon bile duct injuries during laparoscopic cholecystectomy that result in litigation Surg Endosc 12 310–313 Occurrence Handle10.1007/s004649900660 Occurrence Handle9543519

    Article  PubMed  Google Scholar 

  5. MR Ferreira RL Bennett SC Gilman S Mathewson CL Bennett (1999) ArticleTitleDiffusion of laparoscopic cholecystectomy in the Veterans Affairs health care system, 1991–1995 Eff Clin Pract 2 49–55 Occurrence Handle10538476

    PubMed  Google Scholar 

  6. DR Flum T Koepsell P Heagerty M Sinanan EP Dellinger (2001) ArticleTitleCommon bile duct injury during laparoscopic cholecystectomy and the use of intraoperative cholangiography: adverse outcome or preventable error? Arch Surg 136 1287–1292 Occurrence Handle10.1001/archsurg.136.11.1287 Occurrence Handle11695975

    Article  PubMed  Google Scholar 

  7. DR Flum A Cheadle C Prela EP Dellinger L Chan (2003) ArticleTitleBile duct injury during cholecystectomy and survival in medicare beneficiaries JAMA 290 2168–2173 Occurrence Handle10.1001/jama.290.16.2168 Occurrence Handle14570952

    Article  PubMed  Google Scholar 

  8. A Jemal RC Tiwari T Murray A Ghafoor A Samuels E Ward EJ Feuer et al. (2004) ArticleTitleCancer statistics, 2004. CA Cancer J Clin 54 8–29 Occurrence Handle14974761

    PubMed  Google Scholar 

  9. KA Kern (1997) ArticleTitleMalpractice litigation involving laparoscopic cholecystectomy: cost, cause, and consequences Arch Surg 132 392–397; discussion 397–398 Occurrence Handle9108760

    PubMed  Google Scholar 

  10. GB Melton KD Lillemoe JL Cameron PA Sauter J Coleman CJ Yeo (2002) ArticleTitleMajor bile duct injuries associated with laparoscopic cholecystectomy: effect of surgical repair on quality of life Ann Surg 235 388–895 Occurrence Handle10.1097/00000658-200206000-00018

    Article  Google Scholar 

  11. TN Robinson GV Stiegmann JD Durham SI Johnson ME Wachs AD Serra DA Kumpe (2001) ArticleTitleManagement of major bile duct injury associated with laparoscopic cholecystectomy Surg Endosc 15 1381–1385 Occurrence Handle11965450

    PubMed  Google Scholar 

  12. JC Russell SJ Walsh AS Mattie JT Lynch (1996) ArticleTitleBile duct injuries, 1989–1993. A statewide experience. Connecticut Laparoscopic Cholecystectomy Registry Arch Surg 131 382–388 Occurrence Handle8615723

    PubMed  Google Scholar 

  13. SJ Savader KD Lillemoe CA Prescott AB Winick AC Venbrux GB Lund SE Mitchell et al. (1997) ArticleTitleLaparoscopic cholecystectomy-related bile duct injuries: a health and financial disaster Ann Surg 225 268–273 Occurrence Handle10.1097/00000658-199703000-00005 Occurrence Handle9060582

    Article  PubMed  Google Scholar 

  14. FP Schol PM Go DJ Gouma (1994) ArticleTitleRisk factors for bile duct injury in laparoscopic cholecystectomy: analysis of 49 cases Br J Surg 81 1786–1788 Occurrence Handle7827940

    PubMed  Google Scholar 

  15. L Stewart LW Way (1995) ArticleTitleBile duct injuries during laparoscopic cholecystectomy: factors that influence the results of treatment Arch Surg 130 1123–1128 Occurrence Handle7575127

    PubMed  Google Scholar 

  16. B Taylor (1998) ArticleTitleCommon bile duct injury during laparoscopic cholecystectomy in Ontario: does ICD-9 coding indicate true incidence? CmaJ 158 481–490 Occurrence Handle9627560

    PubMed  Google Scholar 

  17. LJ Wudel SuffixJr JK Wright CW Pinson A Herline J Debelak S Seidel K Revis et al. (2001) ArticleTitleBile duct injury following laparoscopic cholecystectomy: a cause for continued concern Am Surg 67 557–563 Occurrence Handle11409804

    PubMed  Google Scholar 

Download references

Acknowledgment

This work was supported by a research grant from the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES).

Author information

Authors and Affiliations

  1. Department of Surgery, Division of General Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, L223A, Portland, OR, USA

    J. P. Dolan, B. S. Diggs, B. C. Sheppard & J. G. Hunter

Authors
  1. J. P. Dolan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. B. S. Diggs
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. B. C. Sheppard
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. G. Hunter
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. P. Dolan.

Additional information

Presented at the annual meeting of the Society of American Gastrointestinal Endoscopic Surgeons (SAGES), Scientific Session, Denver, CO, USA, 31 March–4 April 2004

Appendix. Inclusion and exclusion diagnoses and procedures with associated ICD-9-CM codes.

Appendix. Inclusion and exclusion diagnoses and procedures with associated ICD-9-CM codes.

   
Full size table

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dolan, J.P., Diggs, B.S., Sheppard, B.C. et al. Ten-year trend in the national volume of bile duct injuries requiring operative repair. Surg Endosc 19, 967–973 (2005). https://doi.org/10.1007/s00464-004-8942-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-004-8942-6

Keywords

Search

Navigation