PMCID: PMC3771752, DOI: 10.4293/108680813X13654754535638
BACKGROUND AND OBJECTIVES: Previously, risk factors for bile duct injury have been identified as acute cholecystitis, male gender, older age, aberrant biliary anatomy, and laparoscopic cholecystectomy.
METHODS: A retrospective analysis of the Nationwide Inpatient Sample from 1998 to 2006 was performed with an inclusion criterion of cholecystectomy performed on hospital day 0 or 1. Patient- and hospital-level factors potentially associated with bile duct injury were examined by logistic regression.
RESULTS: A total of 377,424 cholecystectomy patients were identified. There were 1124 bile duct injuries (0.30%), with 177 (0.06%) in the laparoscopic cholecystectomy group and 947 (1.46%) in the open cholecystectomy group (P < .001). On multivariate analysis, significant risk factors for bile duct injury were male gender (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.06-1.38; P = .006), age >60 years (OR, 2.23; 95% CI, 1.61-3.09; P < .001), and academic hospital status (OR, 1.37; 95% CI, 1.05-1.79; P = .02). Acute cholecystitis was associated with a lower risk of bile duct injury (OR, 0.67; 95% CI, 0.46-0.99; P = .044).
CONCLUSION: Independent risk factors for bile duct injury included male gender, age >60 years, and academic hospital status. Laparoscopic cholecystectomy, obesity, insurance status, or hospital volume was not associated with an increased risk of bile duct injury.
JSLS : Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons
Age Factors; Aged; Bile Ducts; Cholecystectomy; Laparoscopic; Female; Humans; Iatrogenic Disease; Intraoperative Complications; Male; Middle Aged; Retrospective Studies; Risk Factors; United States
Gall Bladder Surgery; Laparoscopic; Bile Duct Injury; Risk Factors
Fullum, T. M., Downing, S. R., Ortega, G., Chang, D. C., Oyetunji, T. A., Van Kirk, K., Tran, D. D., Woods, I., Cornwell, E. E., Turner, P. L. Is laparoscopy a risk factor for bile duct injury during cholecystectomy? JSLS : Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons 17, 365-370 (2013).