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Bile duct injuries: a contemporary survey of surgeon attitudes and experiences.
- Source :
-
Surgical endoscopy [Surg Endosc] 2020 Jul; Vol. 34 (7), pp. 3079-3084. Date of Electronic Publication: 2019 Aug 06. - Publication Year :
- 2020
-
Abstract
- Introduction: The incidence of bile duct injury (BDI) during laparoscopic cholecystectomy has not changed significantly in the past 2 decades despite increased operative experience and technical refinement. We sought to evaluate surgeon-specific factors associated with BDI and to assess how surgeons manage injuries.<br />Methods: An online survey was sent to surgeons belonging to the Society of American Gastrointestinal and Endoscopic Surgeons via e-mail. Survey items included personal experience with BDI and how injuries were addressed. Statistical analysis was performed to identify factors associated with BDI.<br />Results: The survey was sent to 3411 surgeons with 559 complete responses (16.5%). The mean age of respondents was 48.7 years with an average time in practice of 16.1 years. Most respondents (61.2%) had fellowship training. Forty-seven percent of surgeons surveyed experienced a BDI in their career with 17.1% of surgeons experiencing multiple BDIs. The majority of BDIs were identified in the operating room (64.5%); most injuries (66.9%) were repaired immediately. When repair was undertaken immediately, 77.4% of these repairs were performed in an open technique. A majority of surgeons (57.7%) felt that BDIs could theoretically be repaired laparoscopically and 25% of those surgeons had done so in practice. In multivariate logistic regression, any type of fellowship training was associated with a decreased risk of BDI (OR 0.51, 95% CI 0.34-0.76). Compared with those in non-academic practice, surgeons in academic practice were at a significantly decreased risk of having experienced a BDI (OR 0.62, 95% CI 0.42-0.92).<br />Conclusion: Nearly half of those surveyed, experienced a BDI during a laparoscopic cholecystectomy. Community and private practice setting were associated with an increased risk of BDI, while fellowship training and academic practice setting conferred a protective effect. A majority of surgeons felt that BDI could be repaired laparoscopically and 25% had done so in practice.
- Subjects :
- Adult
Attitude of Health Personnel
Cholecystectomy, Laparoscopic methods
Cholecystectomy, Laparoscopic statistics & numerical data
Clinical Competence
Health Surveys
Humans
Incidence
Intraoperative Complications epidemiology
Intraoperative Complications etiology
Middle Aged
Bile Ducts injuries
Cholecystectomy, Laparoscopic adverse effects
Surgeons
Subjects
Details
- Language :
- English
- ISSN :
- 1432-2218
- Volume :
- 34
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Surgical endoscopy
- Publication Type :
- Academic Journal
- Accession number :
- 31388804
- Full Text :
- https://doi.org/10.1007/s00464-019-07056-7