BACKGROUND: In 2007, a Dutch guideline for laparoscopic cholecystectomy (LC) was composed that advocates the critical view of safety (CVS) to prevent bile duct injury (BDI). Conversion to open cholecystectomy is recommended in complicated cholecystectomy, but young surgeons are hardly trained in this procedure. The aim of this study was to analyze the accuracy of dictated operation notes, the use of CVS before and after guideline implementation, and the severity of injury after conversion. METHODS: Between 1990 and 2012, 800 patients were referred for treatment of BDI. All available operation notes (n = 528; 66%) were scored for procedural conditions, reasons for conversion, the use of safety measures, and postoperative care in BDI patients. RESULTS: Patient demographics, indication for cholecystectomy, conversion rates, and injury type were comparable to the total cohort of BDI patients. LC (n = 479; 91%) was converted in 180 patients (34%). The CVS technique or dissection of Calot's triangle were reported in 33 patients (6.3%) and 87 patients (16.5%), respectively. Guideline implementation increased the reporting of CVS from 4% (16/425) to 17% (17/103; P < .001), and the consultation of a hepatic-pancreatic-biliary (HPB) colleague from 3% (14/425) to 8% (8/103; P < .01). Conversion to open surgery leads to more complex injury (Bismuth III-V injury rate of 34% [24/64] vs 65% [46/116]; P = .013). CONCLUSION: The insufficient use of safety measures to prevent BDI during LC in this selected patient group is of concern. Although guideline implementation significantly improved the use of CVS during LC, further improvement is necessary. Conversion cannot simply be used as an "escape" procedure, because this may lead to more complex injury.
BACKGROUND: In 2007, a Dutch guideline for laparoscopic cholecystectomy (LC) was composed that advocates the critical view of safety (CVS) to prevent bile duct injury (BDI). Conversion to open cholecystectomy is recommended in complicated cholecystectomy, but young surgeons are hardly trained in this procedure. The aim of this study was to analyze the accuracy of dictated operation notes, the use of CVS before and after guideline implementation, and the severity of injury after conversion. METHODS: Between 1990 and 2012, 800 patients were referred for treatment of BDI. All available operation notes (n = 528; 66%) were scored for procedural conditions, reasons for conversion, the use of safety measures, and postoperative care in BDI patients. RESULTS:Patient demographics, indication for cholecystectomy, conversion rates, and injury type were comparable to the total cohort of BDI patients. LC (n = 479; 91%) was converted in 180 patients (34%). The CVS technique or dissection of Calot's triangle were reported in 33 patients (6.3%) and 87 patients (16.5%), respectively. Guideline implementation increased the reporting of CVS from 4% (16/425) to 17% (17/103; P < .001), and the consultation of a hepatic-pancreatic-biliary (HPB) colleague from 3% (14/425) to 8% (8/103; P < .01). Conversion to open surgery leads to more complex injury (Bismuth III-V injury rate of 34% [24/64] vs 65% [46/116]; P = .013). CONCLUSION: The insufficient use of safety measures to prevent BDI during LC in this selected patient group is of concern. Although guideline implementation significantly improved the use of CVS during LC, further improvement is necessary. Conversion cannot simply be used as an "escape" procedure, because this may lead to more complex injury.
Authors: Joshua Weis; L Michael Brunt; Amin Madani; Dana Telem; Madhuri Nagaraj; Horacio Asbun; Brian R Davis; Sharmila Dissanaike; Michael B Ujiki; Carl J Westcott; Adnan Alseidi Journal: Surg Endosc Date: 2022-08-25 Impact factor: 3.453
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Authors: Yi Jin; Runwen Liu; Yonghua Chen; Jie Liu; Ying Zhao; Ailin Wei; Yichuan Li; Hai Li; Jun Xu; Xin Wang; Ang Li Journal: Front Surg Date: 2022-08-01
Authors: Lucia Ilaria Sgaramella; Angela Gurrado; Alessandro Pasculli; Nicola de Angelis; Riccardo Memeo; Francesco Paolo Prete; Stefano Berti; Graziano Ceccarelli; Marco Rigamonti; Francesco Giuseppe Aldo Badessi; Nicola Solari; Marco Milone; Fausto Catena; Stefano Scabini; Francesco Vittore; Gennaro Perrone; Carlo de Werra; Ferdinando Cafiero; Mario Testini Journal: Surg Endosc Date: 2020-08-11 Impact factor: 4.584
Authors: Philip H Pucher; L Michael Brunt; Neil Davies; Ali Linsk; Amani Munshi; H Alejandro Rodriguez; Abe Fingerhut; Robert D Fanelli; Horacio Asbun; Rajesh Aggarwal Journal: Surg Endosc Date: 2018-03-19 Impact factor: 4.584
Authors: Nicola de'Angelis; Fausto Catena; Riccardo Memeo; Federico Coccolini; Aleix Martínez-Pérez; Oreste M Romeo; Belinda De Simone; Salomone Di Saverio; Raffaele Brustia; Rami Rhaiem; Tullio Piardi; Maria Conticchio; Francesco Marchegiani; Nassiba Beghdadi; Fikri M Abu-Zidan; Ruslan Alikhanov; Marc-Antoine Allard; Niccolò Allievi; Giuliana Amaddeo; Luca Ansaloni; Roland Andersson; Enrico Andolfi; Mohammad Azfar; Miklosh Bala; Amine Benkabbou; Offir Ben-Ishay; Giorgio Bianchi; Walter L Biffl; Francesco Brunetti; Maria Clotilde Carra; Daniel Casanova; Valerio Celentano; Marco Ceresoli; Osvaldo Chiara; Stefania Cimbanassi; Roberto Bini; Raul Coimbra; Gian Luigi de'Angelis; Francesco Decembrino; Andrea De Palma; Philip R de Reuver; Carlos Domingo; Christian Cotsoglou; Alessandro Ferrero; Gustavo P Fraga; Federica Gaiani; Federico Gheza; Angela Gurrado; Ewen Harrison; Angel Henriquez; Stefan Hofmeyr; Roberta Iadarola; Jeffry L Kashuk; Reza Kianmanesh; Andrew W Kirkpatrick; Yoram Kluger; Filippo Landi; Serena Langella; Real Lapointe; Bertrand Le Roy; Alain Luciani; Fernando Machado; Umberto Maggi; Ronald V Maier; Alain Chichom Mefire; Kazuhiro Hiramatsu; Carlos Ordoñez; Franca Patrizi; Manuel Planells; Andrew B Peitzman; Juan Pekolj; Fabiano Perdigao; Bruno M Pereira; Patrick Pessaux; Michele Pisano; Juan Carlos Puyana; Sandro Rizoli; Luca Portigliotti; Raffaele Romito; Boris Sakakushev; Behnam Sanei; Olivier Scatton; Mario Serradilla-Martin; Anne-Sophie Schneck; Mohammed Lamine Sissoko; Iradj Sobhani; Richard P Ten Broek; Mario Testini; Roberto Valinas; Giorgos Veloudis; Giulio Cesare Vitali; Dieter Weber; Luigi Zorcolo; Felice Giuliante; Paschalis Gavriilidis; David Fuks; Daniele Sommacale Journal: World J Emerg Surg Date: 2021-06-10 Impact factor: 5.469