Frequency of biliary complications after laparoscopic cholecystectomy detected by ERCP

experience at a large tertiary referral center{A figure is presented}

Mubashir H. Khan, Thomas Howard, Evan Fogel, Stuart Sherman, Lee McHenry, James L. Watkins, David F. Canal, Glen Lehman

Research output: Contribution to journalArticle

71 Citations (Scopus)

Abstract

Background: Laparoscopic cholecystectomy has a higher incidence of bile-duct injuries than open cholecystectomy. Although a learning curve phenomenon was attributed to biliary injuries early after its introduction, we were interested in trends in biliary injury rates over time as laparoscopic cholecystectomy has become a mature technology. Objective: To analyze the frequency and anatomic distribution of bile-duct injuries referred after laparoscopic cholecystectomy over a 10-year period. Design: Retrospective, case-series. Setting: Tertiary, referral hepatobiliary unit. Patients: Referrals to ERCP unit for diagnosis and treatment of biliary injuries after laparoscopic cholecystectomy. Intervention: ERCP to diagnose level and severity of bile duct injury. Main Outcome Measurements: Type and anatomy of bile-duct injury, reason for cholecystectomy, mean time between injury and diagnosis, presenting symptoms, ratio of bile-duct injuries diagnosed over total ERCPs done per year. Results: There were 87 bile-duct leaks, 28 leaks with stones, 51 strictures, and 17 complete duct transactions. The bile-duct injury rate calculated per 100 ERCPs per year was 0.84 (1994), 0.99 (1995), 1.36 (1996), 1.41 (1997), 1.03 (1998), 1.31 (1999), 0.84 (2000), 0.75 (2001), 1.15 (2002), and 0.94 (2003). Limitations: Single institution, retrospective analysis, unknown denominator of cholecystectomies done in referral area per year to calculate true bile-duct injury rate. Conclusions: Static incidence in frequency, anatomic distribution, and rate per 100 ERCPs per year of postcholecystectomy bile-duct injuries at a tertiary referral hepatobiliary unit over a 10-year period of observation.

Original languageEnglish
Pages (from-to)247-252
Number of pages6
JournalGastrointestinal Endoscopy
Volume65
Issue number2
DOIs
StatePublished - Feb 2007

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Endoscopic Retrograde Cholangiopancreatography
Laparoscopic Cholecystectomy
Tertiary Care Centers
Bile Ducts
Wounds and Injuries
Cholecystectomy
Referral and Consultation
Learning Curve
Incidence
Anatomy
Pathologic Constriction
Observation

ASJC Scopus subject areas

  • Gastroenterology

Cite this

@article{cdf59d1901bb4b30ac1fc9c528b503cf,
title = "Frequency of biliary complications after laparoscopic cholecystectomy detected by ERCP: experience at a large tertiary referral center{A figure is presented}",
abstract = "Background: Laparoscopic cholecystectomy has a higher incidence of bile-duct injuries than open cholecystectomy. Although a learning curve phenomenon was attributed to biliary injuries early after its introduction, we were interested in trends in biliary injury rates over time as laparoscopic cholecystectomy has become a mature technology. Objective: To analyze the frequency and anatomic distribution of bile-duct injuries referred after laparoscopic cholecystectomy over a 10-year period. Design: Retrospective, case-series. Setting: Tertiary, referral hepatobiliary unit. Patients: Referrals to ERCP unit for diagnosis and treatment of biliary injuries after laparoscopic cholecystectomy. Intervention: ERCP to diagnose level and severity of bile duct injury. Main Outcome Measurements: Type and anatomy of bile-duct injury, reason for cholecystectomy, mean time between injury and diagnosis, presenting symptoms, ratio of bile-duct injuries diagnosed over total ERCPs done per year. Results: There were 87 bile-duct leaks, 28 leaks with stones, 51 strictures, and 17 complete duct transactions. The bile-duct injury rate calculated per 100 ERCPs per year was 0.84 (1994), 0.99 (1995), 1.36 (1996), 1.41 (1997), 1.03 (1998), 1.31 (1999), 0.84 (2000), 0.75 (2001), 1.15 (2002), and 0.94 (2003). Limitations: Single institution, retrospective analysis, unknown denominator of cholecystectomies done in referral area per year to calculate true bile-duct injury rate. Conclusions: Static incidence in frequency, anatomic distribution, and rate per 100 ERCPs per year of postcholecystectomy bile-duct injuries at a tertiary referral hepatobiliary unit over a 10-year period of observation.",
author = "Khan, {Mubashir H.} and Thomas Howard and Evan Fogel and Stuart Sherman and Lee McHenry and Watkins, {James L.} and Canal, {David F.} and Glen Lehman",
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T1 - Frequency of biliary complications after laparoscopic cholecystectomy detected by ERCP

T2 - experience at a large tertiary referral center{A figure is presented}

AU - Khan, Mubashir H.

AU - Howard, Thomas

AU - Fogel, Evan

AU - Sherman, Stuart

AU - McHenry, Lee

AU - Watkins, James L.

AU - Canal, David F.

AU - Lehman, Glen

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N2 - Background: Laparoscopic cholecystectomy has a higher incidence of bile-duct injuries than open cholecystectomy. Although a learning curve phenomenon was attributed to biliary injuries early after its introduction, we were interested in trends in biliary injury rates over time as laparoscopic cholecystectomy has become a mature technology. Objective: To analyze the frequency and anatomic distribution of bile-duct injuries referred after laparoscopic cholecystectomy over a 10-year period. Design: Retrospective, case-series. Setting: Tertiary, referral hepatobiliary unit. Patients: Referrals to ERCP unit for diagnosis and treatment of biliary injuries after laparoscopic cholecystectomy. Intervention: ERCP to diagnose level and severity of bile duct injury. Main Outcome Measurements: Type and anatomy of bile-duct injury, reason for cholecystectomy, mean time between injury and diagnosis, presenting symptoms, ratio of bile-duct injuries diagnosed over total ERCPs done per year. Results: There were 87 bile-duct leaks, 28 leaks with stones, 51 strictures, and 17 complete duct transactions. The bile-duct injury rate calculated per 100 ERCPs per year was 0.84 (1994), 0.99 (1995), 1.36 (1996), 1.41 (1997), 1.03 (1998), 1.31 (1999), 0.84 (2000), 0.75 (2001), 1.15 (2002), and 0.94 (2003). Limitations: Single institution, retrospective analysis, unknown denominator of cholecystectomies done in referral area per year to calculate true bile-duct injury rate. Conclusions: Static incidence in frequency, anatomic distribution, and rate per 100 ERCPs per year of postcholecystectomy bile-duct injuries at a tertiary referral hepatobiliary unit over a 10-year period of observation.

AB - Background: Laparoscopic cholecystectomy has a higher incidence of bile-duct injuries than open cholecystectomy. Although a learning curve phenomenon was attributed to biliary injuries early after its introduction, we were interested in trends in biliary injury rates over time as laparoscopic cholecystectomy has become a mature technology. Objective: To analyze the frequency and anatomic distribution of bile-duct injuries referred after laparoscopic cholecystectomy over a 10-year period. Design: Retrospective, case-series. Setting: Tertiary, referral hepatobiliary unit. Patients: Referrals to ERCP unit for diagnosis and treatment of biliary injuries after laparoscopic cholecystectomy. Intervention: ERCP to diagnose level and severity of bile duct injury. Main Outcome Measurements: Type and anatomy of bile-duct injury, reason for cholecystectomy, mean time between injury and diagnosis, presenting symptoms, ratio of bile-duct injuries diagnosed over total ERCPs done per year. Results: There were 87 bile-duct leaks, 28 leaks with stones, 51 strictures, and 17 complete duct transactions. The bile-duct injury rate calculated per 100 ERCPs per year was 0.84 (1994), 0.99 (1995), 1.36 (1996), 1.41 (1997), 1.03 (1998), 1.31 (1999), 0.84 (2000), 0.75 (2001), 1.15 (2002), and 0.94 (2003). Limitations: Single institution, retrospective analysis, unknown denominator of cholecystectomies done in referral area per year to calculate true bile-duct injury rate. Conclusions: Static incidence in frequency, anatomic distribution, and rate per 100 ERCPs per year of postcholecystectomy bile-duct injuries at a tertiary referral hepatobiliary unit over a 10-year period of observation.

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