Bile duct injury during laparoscopic cholecystectomy: a prospective nationwide series

摘要: Background The risk of bile duct injury in laparoscopic cholecystectomy has been a concern since the procedure became part surgical armamentarium. Our study assesses incidence, types, and treatment for injury. Study design Prospective case registration national database with participation by all departments surgery performing Denmark first operation January 1991. notes have reviewed. Results From 1991 through 1994, 57 7,654 patients sustained (0.74 percent; 95 percent confidence interval, 0.55 to 0.94 percent), including nine injuries occurring after conversion. annual incidence did not decrease. Thirty-nine were incisions, 39 transections, 12 clip or strictures. One patient, who transection during open reoperation bleeding converted procedure, died. Bile leaks reasons other than occurred 2.1 71 these cystic leaks. Acute cholecystitis was indication 968 patients, 1.3 sustaining (95 0.62 2.08 while indications 0.44 0.82 percent) (p > 0.05). Preoperative knowledge anatomy available means preoperative endoscopic retrograde cholangiopancreatography intravenous cholangiography 26 undergoing but this reduce frequency had intraoperative significantly different from those not. Intraoperative done 14 cases (diagnostic 8, misinterpreted 2, normal 4 patients). described operative difficulties 11 48 injury, most often because fibrosis difficulty delineating anatomy. Conclusions is higher previously generally anticipated decrease 1994. Risk factors possible preventive measures should be evaluated prospective studies.