• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy-Coming Soon!
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

Gallbladder Damage Control: Compromised Procedure for Compromised Patients

Justin Lee, MD, Reza Kermani, MD, Haisar Dao, MD, Kevin F O’donnell, MD. St. Elizabeth Medical Center, Tufts University School of Medicine

 

Introduction
As experience of open cholecystectomy has decreased significantly in the past two decades both in surgical practice and training, open cholecystectomy is generally performed for severe inflammation necessitating conversion to an open procedure or suspected malignancy. Literature describes partial cholecystectomy (PC), laparoscopic partial cholecystectomy (LPC), and trocar cholecystostomy (TC) in an effort to avoid common bile duct injury. PC however is not without complications with recent case reports of recurrent biliary stone and “stump” cholecystitis. The objectives of this study were to 1) analyze recent nine year trends in utilization of PC, LPC, and TC, 2) characterize patient and hospital variables, and 3) identify associated variables for common bile duct injury. 

Methods
Retrospective cohort analysis of the Nationwide Inpatient Sample (NIS) files from 2000 to 2008 was performed. For the purpose of the study, gallbladder damage control was defined as PC, LPC, and TC. Data analysis included patient demographics, diagnoses, procedures, complications, hospital characteristics, length of stay, total hospital charges, and inpatient mortality.

Results
A national estimate of 10,872 gallbladder damage control cases were identified, characterized by mean age 61.12 (0.18, SEM) years old, 50.6% female, 67.9% white, and 14.5% Hispanic. Most common diagnoses were, calculus gallbladder cholecystitis (49.4%), acalculus cholecystitis (20.9%), and pancreatitis (10.7%). Procedures performed included PC (47.8%), LPC (27.2%), TC (25.3%), and intraoperative cholangiogram (IOC) (19.7%). 13.6% postoperative complications were identified, including pulmonary complications (4.3%), hemorrhage/hematoma/seroma (3.4%), and accidental puncture or laceration during procedure (3.3%). Common bile duct injury occurred in 3.3% overall. Hospital characteristics included non-teaching (82.1%), urban hospitals (67.8%), and regional variations of 42.1% from the South and 45.2% from the West. Inpatient outcomes included: mean length of stay of 11.4 days (0.16, SEM), mean total hospital charge of $71,296.69 (1106.03, SEM), 7.4% mortality, and 16.8% discharges to skilled nursing facility. Multivariate logistic regression analysis identified assoicated variables for common bile duct injury: pancreatitis (1.38 OR, 1.03-1.86 CI, P=0.031), open PC (2.98 OR, 2.18-4.07 CI, P<0.001), and teaching hospitals (1.48 OR, 1.13-1.94 CI, P=0.004). IOC was a commonly associated procedure in the setting of common bile duct injury (2.03 OR, 1.59-2.59 CI, P<0.001).

Conclusion
Various circumstances may require gallbladder damage control with PC, LPC, and TC. Postoperative complications and common bile duct injury remain significantly high despite limited resection. We found pancreatitis, open PC, use of IOC, and teaching status of hospitals to be associated with common bile duct injury. High morbidity and mortality of gallbladder damage control may reflect both compromised nature of the procedures and multiple comorbidities.
 


Session Number: ResFel – Residents/Fellows Scientific Session
Program Number: S135

239

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2012 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Critical View of Safety (CVS) Challenge QR Code

The SAGES Critical View of Safety Challenge – Donate Your Lap Chole Videos!

The Society of American Gastrointestinal and Endoscopic Surgeons is hosting the first Artificial Intelligence Data Challenge conducted by surgeons. The aim of this challenge is to generate a large and diverse dataset of laparoscopic cholecystectomy videos, annotated with respect to the subcomponents of the Critical View of Safety (CVS). Computer scientists from all over the […]

Respuesta de SAGES al Estudio NordICC sobre el beneficio de las colonoscopias de detección

SAGES desea aclarar los resultados del estudio NordICC y colocarlos en contexto de los esfuerzos de varias agencias nacionales para reducir el riesgo de cáncer colorrectal – la segunda causa de muerte por cáncer más frecuente en los Estados Unidos-, mediante la promoción de la detección y tratamiento oportuno de las lesiones.

SAGES Response to NordICC Study Regarding Benefit of Screening Colonoscopies

The NordICC Study recently published in The New England Journal of Medicine and widely reported on by media outlets has raised questions regarding the benefit of screening colonoscopy in lowering the risk of colorectal cancer and cancer-related deaths among otherwise healthy and symptom-free men and women aged 55 to 64. Provocative headlines and commentaries have […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons