Introduction: Our aim was to determine the number of bile duct injuries requiring biliary reconstruction after laparoscopic cholecystectomy in England over a 5 year period, and to investigate factors associated with increased risk of bile duct injury.
Methods: Hospital Episode Statistics (HES) Data were obtained from the UK Department of Health for a 5 year period from 2001-2006. Patients undergoing laparoscopic cholecystectomy (LC) and biliary reconstruction were identified using diagnostic codes (OPSC4) and the data analyzed using an MS Access database.
Results: The number of cholecystectomies increased year on year from 33569 in 2001/2 to 46243 in 2005/6 and the percentage of emergency cholecystectomies increased over the same time period from 9.47% to 12.28%. The percentage of patients who underwent laparoscopic cholecystectomy and required subsequent biliary reconstruction was similar (0.22 % 0.25%, 0.24%, 0.21%) in the first 4years studied, but showed a decrease in the final year (2005/6) to 0.16%. Male sex was significantly associated with bile duct injury requiring biliary reconstruction.
Conclusion: Biliary reconstruction following laparoscopic cholecystectomy is rare. There has been a gradual increase in both the total number of laparoscopic cholecystectomies and the number of emergency cholecystectomies performed over the last 5 years in England. Bile duct injury rates do not appear to be increasing and may even be falling, but more data is needed to confirm this trend. Biliary injury is more common in men.
Program Number: P200