Risk factors for bile duct injury after laparoscopic cholecystectomy

Dong, Chang-Cheng; Jiang, Xuejun; Li, Bing; Liang, Chen

doi:10.1097/md.0000000000028191

Cited by 2 publications

(1 citation statement)

References 15 publications

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“…[23] 1674-361X (2016) 10-0063-02 C 8/1350 2007.03-2016.03 ①②⑦ 6 Jin, 2017 [24] 10.19528/j. [25] Not mentioned C 21/383 2013.01-2015.05 ①②④⑦⑧ 8 Long, 2015 [26] 10.3969/j.issn.1671-8348.2015.02.027 C 16/1244 2003.12-2013.12 ①④⑥⑦⑧ 8 Peng, 2019 [27] 10.3969/j.issn.2095-140X.2019. 07.…”

Section: Sensitivity Testunclassified

Analysis of risk factors for bile duct injury in laparoscopic cholecystectomy in China: A systematic review and meta-analysis

Shen¹,

Hu²,

Gu³

et al. 2022

Medicine

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Background: To explore the risk factors of bile duct injury in laparoscopic cholecystectomy (LC) in China through meta-analysis. Methods: The study commenced with a search and selection of case–control studies on the risk factors for bile duct injury in LC in China using the following databases: PubMed, EMBASE, ScienceNet.cn, CNKI, Wanfang Data, and VIP. Data were extracted from the collected documents independently by 2 researchers, following which a meta-analysis of these data was performed using Revman 5.3. Results: The compilation of all data from a total of 19 case–control studies revealed that among 41,044 patients, 458 patients experienced bile duct injury in LC, accounting for the incidence rate of 1.12% for bile duct injury. The revealed risk factors for bile duct injury were age (≥40 years) (odds ratio [OR] = 6.23, 95% CI [95% confidence interval]: 3.42–11.33, P < .001), abnormal preoperative liver function (OR = 2.01, 95% CI: 1.50–2.70, P < .001), acute and subacute inflammation of gallbladder (OR = 8.35, 95% CI: 5.32–13.10, P < .001; OR = 4.26, 95% CI: 2.73–6.65, P < .001), thickening of gallbladder wall (≥4 mm) (OR = 3.18, 95% CI: 2.34–4.34, P < .001), cholecystolithiasis complicated with effusion (OR = 3.05, 95% CI: 1.39–6.71, P = .006), and the anatomic variations of the gallbladder triangle (OR = 11.82, 95% CI: 6.32–22.09, P < .001). However, the factors of gender and overweight (body mass index ≥ 25 kg/m 2 ) were not significantly correlated with bile duct injury in LC. Conclusions: In the present study, age (≥40 years), abnormal preoperative liver function, gallbladder wall thickening, acute and subacute inflammation of the gallbladder, cholecystolithiasis complicated with effusion, and anatomic variations of the gallbladder triangle were found to be closely associated with bile duct injury in LC.

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Section: Sensitivity Testunclassified

Analysis of risk factors for bile duct injury in laparoscopic cholecystectomy in China: A systematic review and meta-analysis

Shen¹,

Hu²,

Gu³

et al. 2022

Medicine

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Laparoscopic modified fundus-down cholecystectomy technique: an alternative method for performing a safe laparoscopic cholecystectomy: how to article

Jearanai

Wangkulangkul

Sakolprakaikit

et al. 2023

Annals of Medicine &Amp; Surgery

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Background: Modified fundus-down cholecystectomy is a surgical procedure used to treat patients diagnosed with benign gallbladder disease. This technique begins with Calot’s triangle dissection and attempts to identify key structures such as the cystic artery and duct. Subsequently, fundus-down dissection is performed to separate the gallbladder from the cystic plate. The cystic artery and duct are the final structures that are clipped and cut. In this study, the authors discuss the success and complication rates of this treatment based on their 10-year experience at a tertiary hospital in southern Thailand. Objectives: This study aimed to compare the operative outcomes of conventional laparoscopic cholecystectomy (LC) and modified fundus-down techniques regarding postoperative complications and consequences. Methods: A retrospective analysis of single-centre data from 2010 to 2022 was conducted at our hospital. All patients with gallstone disease who underwent conventional LC or modified fundus-down cholecystectomy were included in the study. The primary outcomes of this study were the incidence of major bile duct injury and the need for further intervention or surgical correction. Results: From a total of 1993 patients who were surveyed, 1612 patients underwent conventional LC and 381 underwent laparoscopic modified fundus-down cholecystectomy. In terms of conversion rate, estimated blood loss, length of hospital stay, and complication rate, there were no differences between the conventional LC and the modified fundus-down approach. However, modified fundus-down cholecystectomy reduced the operative time. The authors collected data from each patient’s sign-in to extubation time (P<0.001). The postoperative complications (P=0.120) and conversion rates (P=0.904) were similar. Conclusion: Laparoscopic modified fundus-down cholecystectomy can be performed in simple and complex cases, including cases of severe fibrosis of the hepatocystic triangle. The study showed that this alternative technique could reduce operative time compared to the conventional technique with no difference in complications, especially common bile duct injury, postoperative common bile duct stones, and postoperative pancreatitis.

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Risk factors for bile duct injury after laparoscopic cholecystectomy

Cited by 2 publications

References 15 publications

Analysis of risk factors for bile duct injury in laparoscopic cholecystectomy in China: A systematic review and meta-analysis

Analysis of risk factors for bile duct injury in laparoscopic cholecystectomy in China: A systematic review and meta-analysis

Laparoscopic modified fundus-down cholecystectomy technique: an alternative method for performing a safe laparoscopic cholecystectomy: how to article

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