title: Asian race/ethnicity as a risk factor for bile duct injury during cholecystectomy.
abstract: Iatrogenic bile duct injury (BDI) is an uncommon but serious complication of cholecystectomy, with identified risk factors of acute cholecystitis, male sex, older age, and aberrant biliary anatomy. The Nationwide Inpatient Sample (1998-2006) was queried for cholecystectomy performed on hospital day 0 or 1. Bile duct injury repair procedure codes were used as a surrogate for BDI. We identified 377,424 patients who underwent cholecystectomy, with 1124 BDIs (0.3%). On multivariate logistic regression analysis, Asian race/ethnicity was a significant risk factor for BDI (odds ratio [OR], 2.26; 95% confidence interval [CI], 1.59-3.23; P < .001). This persisted for laparoscopic (OR, 2.62; 95% CI, 1.28-5.39; P = .009) and open (2.21; 1.59-3.07; P < .001) cholecystectomies. No other race/ethnicity was identified as a risk factor for BDI. We report a new finding that Asian race/ethnicity is a significant risk factor for BDI in laparoscopic and open cholecystectomies.
authors: Department of Surgery, The Johns Hopkins University School of Medicine, 1650 Orleans St, Baltimore, MD 21287, USA.
authors: Stephanie R
authors: SR
authors: Downing
authors: Ghazala
authors: G
authors: Datoo
authors: Tolulope A
authors: TA
authors: Oyetunji
authors: Terrence
authors: T
authors: Fullum
authors: David C
authors: DC
authors: Chang
authors: Nita
authors: N
authors: Ahuja
mesh_terms: D000208:Acute Disease; D001213:Asian / Q000706:statistics & numerical data*; D001652:Bile Ducts / Q000293:injuries*; D002763:Cholecystectomy / Q000009:adverse effects; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D002764:Cholecystitis / Q000208:ethnology* / Q000601:surgery; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors