Bile duct injuries associated with laparoscopic and open cholecystectomy: an 11-year experience in one institute.
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.
Diamantis
Theodoros
T
First Surgical Department, Medical School, University of Athens, Laiko Hospital, 17 Aghiou Thoma Street, GR-115-27, Athens, Greece.
Tsigris
Christos
C
Kiriakopoulos
Andreas
A
Papalambros
Efstathios
E
Bramis
John
J
Michail
Panagiotis
P
Felekouras
Evangelos
E
Griniatsos
John
J
Rosenberg
Theofilos
T
Kalahanis
Nikolaos
N
Giannopoulos
Athanassios
A
Bakoyiannis
Christos
C
Bastounis
Elias
E
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