Risk Tolerance and Bile Duct Injury: Surgeon Characteristics, Risk-Taking Preference, and Common Bile Duct Injuries

Delphi consensus on bile duct injuries during laparoscopic cholecystectomy: an evolutionary cul‐de‐sac or the birth pangs of a new technical framework?

“…Moreover, the ratio was dependent on the number of lifetime cases of cholecystectomies and it reached >80% among surgeons who had performed >1,000 cases, which was similar to the observation by Massarweh et al [31]. The question we should ask to ourselves is: Is BDI an inherent complication associated with LC and is it inevitable regardless of a surgeon's experience?…”

“…Therefore, the answer to the aforementioned question might be "Yes" for the time being, disappointingly, but we hold the responsibility to consolidate a global effort to launch a novel technical framework and solve this problem. Massarweh et al [31] also mentioned in their study that the risk of BDI was lower in hospitals that had a surgical residency program, underscoring the paramount importance of constantly raising awareness of BDI through surgical education. Otto Von Bismarck once said "Fools say they learn from experience; I prefer to learn from the experience of others."…”

“…Previous population-based studies listed male gender, elderly patients, delayed surgery, severity of acute cholecystitis, surgeons' experience, and academic hospital setting etc. [27,31,32] (Table 6); however, very few specifically looked at the surgical techniques or the landmarks that have been reported as important in preventing BDI. In the present study, we shed light on the mechanisms of BDI as well as perception of surgeons on risk management.…”

Comparing early and delayed repair of common bile duct injury to identify clinical drivers of outcome and morbidity

“…1,2 Though a recent publication describes a decreasing rate of CBDI associated with laparoscopic cholecystectomy, 3 CBDI remains a serious concern for patients and surgeons. Despite studies identifying patient 1,4,5 and surgeon-related [5][6][7] factors associated with CBDI including inflammation and conversion to open cholecystectomy, approximately 30% of CBDI are not identified during the index operation 8 and may not be recognized until several days after the initial injury.…”

Lesões iatrogênicas das vias biliares: como prevenir?

“…In a survey done by Massarweh, et al 8 , with 1412 surgeons from the American College of Surgeons, there were data on which younger and more experienced surgeons who had their practice in university hospitals had statistically lower number of iatrogenic injuries of bile duct .…”