title: Comparative analysis of iatrogenic injury of biliary tract in laparotomic and laparoscopic cholecystectomy.
abstract: BACKGROUND
  Iatrogenic injury to the bile ducts is the most feared complication of cholecystectomy and several are the possibilities to occur.
  
  
  OBJECTIVE
  To compare the cases of iatrogenic lesions of the biliary tract occurring in conventional and laparoscopic cholecystectomy, assessing the likely causal factors, complications and postoperative follow-up.
  
  
  METHODS
  Retrospective cohort study with analysis of records of patients undergoing conventional and laparoscopic cholecystectomy. All the patients were analyzed in two years. The only criterion for inclusion was to be operative bile duct injury, regardless of location or time of diagnosis. There were no exclusion criteria. Epidemiological data of patients, time of diagnosis of the lesion and its location were analyzed.
  
  
  RESULTS
  Total of 515 patients with gallstones was operated, 320 (62.1 %) by laparotomy cholecystectomy and 195 by laparoscopic approach. The age of patients with bile duct injury ranged from 29-70 years. Among those who underwent laparotomy cholecystectomy, four cases were diagnosed (1.25 %) with lesions, corresponding to 0.77 % of the total patients. No patient had iatrogenic interventions with laparoscopic surgery.
  
  
  CONCLUSIONS
  Laparoscopic cholecystectomy compared to laparotomy, had a lower rate of bile duct injury.
authors: Departament of Surgery, Hospital Ipiranga UGA-II, São Paulo, SP, Brazil.
authors: André Augusto
authors: AA
authors: Fortunato
authors: Departament of Surgery, Hospital Ipiranga UGA-II, São Paulo, SP, Brazil.
authors: João Kleber de Almeida
authors: JK
authors: Gentile
authors: Departament of Surgery, Hospital Ipiranga UGA-II, São Paulo, SP, Brazil.
authors: Diogo Peral
authors: DP
authors: Caetano
authors: Departament of Surgery, Hospital Ipiranga UGA-II, São Paulo, SP, Brazil.
authors: Marcus Aurélio Zaia
authors: MA
authors: Gomes
authors: Departament of Surgery, Hospital Ipiranga UGA-II, São Paulo, SP, Brazil.
authors: Marco Antônio
authors: MA
authors: Bassi
mesh_terms: D000328:Adult; D000368:Aged; D001659:Biliary Tract / Q000293:injuries*; D002763:Cholecystectomy / Q000379:methods*; D017081:Cholecystectomy, Laparoscopic; D015331:Cohort Studies; D006801:Humans; D007049:Iatrogenic Disease; D007431:Intraoperative Complications / Q000453:epidemiology*; D007813:Laparotomy; D008875:Middle Aged; D012189:Retrospective Studies
references: Scand J Surg. 2011;100(1):42-8
references: 21482504
references: Rev Col Bras Cir. 2011 Mar-Apr;38(2):95-9
references: 21710046
references: JSLS. 2010 Apr-Jun;14(2):268-71
references: 20932382
references: World J Gastroenterol. 2009 Sep 7;15(33):4097-104
references: 19725140
references: Br J Radiol. 2010 Apr;83(988):351-61
references: 20335441
references: Surg Endosc. 2011 Aug;25(8):2449-61
references: 21487883
references: Ann Surg. 2000 Sep;232(3):430-41
references: 10973393
references: Br J Surg. 2006 Feb;93(2):158-68
references: 16432812
references: Scand J Gastroenterol Suppl. 1999;230:89-94
references: 10499468
references: HPB (Oxford). 2008;10(1):4-12
references: 18695753
references: J Med Case Rep. 2009 Jan 31;3:44
references: 19183495
references: Hepatobiliary Pancreat Dis Int. 2007 Oct;6(5):459-63
references: 17897905
references: World J Gastroenterol. 2007 Apr 28;13(16):2374-8
references: 17511041
references: Hepatogastroenterology. 2011 May-Jun;58(107-108):719-24
references: 21830376