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Bile Duct Injuries Associated with Laparoscopic and Open Cholecystectomy: An 11-Year Experience in One Institute
Authors:Theodoros Diamantis  Christos Tsigris  Andreas Kiriakopoulos  Efstathios Papalambros  John Bramis  Panagiotis Michail  Evangelos Felekouras  John Griniatsos  Theofilos Rosenberg  Nikolaos Kalahanis  Athanassios Giannopoulos  Christos Bakoyiannis  Elias Bastounis
Affiliation:(1) First Surgical Department, Medical School, University of Athens, Laiko Hospital, 17 Aghiou Thoma Street, GR-115-27 Athens, Greece
Abstract:Purpose 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, 3 637 patients underwent cholecystectomy in our department; as LC in 2 079 patients (LC group) and as OC in 1 558 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.Conclusion 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.
Keywords:Laparoscopic cholecystectomy  Learning curve for laparoscopic cholecystectomy  Open cholecystectomy  Bile duct injury
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