Document Type

Article

Publication Date

7-1-2013

Identifier

PMCID: PMC3771752, DOI: 10.4293/108680813X13654754535638

Abstract

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.

Journal Title

JSLS : Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons

Volume

17

Issue

3

First Page

365

Last Page

370

MeSH Keywords

Age Factors; Aged; Bile Ducts; Cholecystectomy; Laparoscopic; Female; Humans; Iatrogenic Disease; Intraoperative Complications; Male; Middle Aged; Retrospective Studies; Risk Factors; United States

Keywords

Gall Bladder Surgery; Laparoscopic; Bile Duct Injury

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