Document Detail


Bile duct injury during laparoscopic cholecystectomy: myth or reality of the learning curve?
MedLine Citation:
PMID:  10948294     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Bile duct injury (BDI) is a severe complication of laparoscopic cholecystectomy (LC) that is probably related to the effects of the learning curve. The aim of this prospective, institutional, and longitudinal study is to compare the incidence of BDI during LC in relation to the progressive experience of surgeons. METHODS: A total of 784 LC were examined during a 6-year period. They were divided into the following three consecutive groups: group A (1993-94), group B (1995-96), and group C (1997-98). Incidence and type of BDI, experience of the surgeon, intra- or postoperative diagnosis, treatment performed to repair the injury, and early and late morbidity and mortality were evaluated. RESULTS: The overall incidence of BDI was 1.4%. There were three cases of transection of the common bile duct, four partial lesions of the bile duct, and four cystic leakages. The number of BDI was maintained over the three different time periods; there were no statistical differences in the proportion of injuries among groups. Most BDI were incurred by experienced surgeons. In all, 36% of BDI were recognized intraoperatively. Hepaticojejunostomy, direct suture over a T-tube, and closure of the cystic stump were done to repair BDI. There was no additional morbidity or mortality in the patients with BDI. CONCLUSIONS: No relation was found between the experience of the surgeon and the number of BDI over the different periods of time. Therefore, BDI during LC cannot be attributed solely to the learning curve.
Authors:
J Calvete; L Sabater; B Camps; A Verdú; A Gomez-Portilla; J Martín; M A Torrico; B Flor; N Cassinello; S Lledó
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgical endoscopy     Volume:  14     ISSN:  0930-2794     ISO Abbreviation:  Surg Endosc     Publication Date:  2000 Jul 
Date Detail:
Created Date:  2001-02-02     Completed Date:  2001-02-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8806653     Medline TA:  Surg Endosc     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  608-11     Citation Subset:  IM    
Affiliation:
Department of Surgery, Hospital Clínico, University of Valencia, Spain.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Bile Ducts / injuries*
Cholecystectomy, Laparoscopic*
Clinical Competence
Female
Humans
Intraoperative Complications / epidemiology*,  prevention & control
Male
Middle Aged
Prospective Studies
Time Factors
Comments/Corrections
Comment In:
Surg Endosc. 2000 Jul;14(7):605-7   [PMID:  10948293 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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