title: Bile duct injuries associated with laparoscopic and open cholecystectomy: an 11-year experience in one institute.
abstract: OBJECTIVE
  Bile duct injury (BDI) represents the most serious complication of laparoscopic cholecystectomy (LC). The aim of this retrospective single-institution study was to evaluate the real incidence of BDI during laparoscopic and open cholecystectomy (OC) in a tertiary academic center in Athens, Greece.
  
  
  METHODS
  Between January 1991 and December 2001, 3637 patients underwent cholecystectomy in our department; as LC in 2079 patients (LC group) and as OC in 1558 patients (OC group). All the LCs were performed or supervised by five staff surgeons and all the OCs were performed or supervised by another five staff surgeons.
  
  
  RESULTS
  There were 13 BDIs associated with LC (0.62%) and 6 associated with OC (0.38%) (P = 0.317). There was one death associated with BDI after LC. Only two (15.4%) of the BDIs associated with LC occurred within the proposed learning curve limit of 50 LCs per individual surgeon.
  
  
  CONCLUSIONS
  Laparoscopic cholecystectomy is safe and is not associated with a higher incidence of BDI than OC. Moreover, we did not find that the learning curve for LC affected BDI occurrence.
authors.affiliation: First Surgical Department, Medical School, University of Athens, Laiko Hospital, 17 Aghiou Thoma Street, GR-115-27, Athens, Greece.
authors.forename: Theodoros
authors.initials: T
authors.lastname: Diamantis
authors.forename: Christos
authors.initials: C
authors.lastname: Tsigris
authors.forename: Andreas
authors.initials: A
authors.lastname: Kiriakopoulos
authors.forename: Efstathios
authors.initials: E
authors.lastname: Papalambros
authors.forename: John
authors.initials: J
authors.lastname: Bramis
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Michail
authors.forename: Evangelos
authors.initials: E
authors.lastname: Felekouras
authors.forename: John
authors.initials: J
authors.lastname: Griniatsos
authors.forename: Theofilos
authors.initials: T
authors.lastname: Rosenberg
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Kalahanis
authors.forename: Athanassios
authors.initials: A
authors.lastname: Giannopoulos
authors.forename: Christos
authors.initials: C
authors.lastname: Bakoyiannis
authors.forename: Elias
authors.initials: E
authors.lastname: Bastounis
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D001649:Bile Duct Diseases / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D001652:Bile Ducts / Q000293:injuries*; D002763:Cholecystectomy / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D007813:Laparotomy / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D015996:Survival Rate