Asian race/ethnicity as a risk factor for bile duct injury during cholecystectomy.
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.
Downing
Stephanie R
SR
Department of Surgery, The Johns Hopkins University School of Medicine, 1650 Orleans St, Baltimore, MD 21287, USA.
Datoo
Ghazala
G
Oyetunji
Tolulope A
TA
Fullum
Terrence
T
Chang
David C
DC
Ahuja
Nita
N
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