• 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

Increasing common bile duct injury and decreasing utilization of Intra-operative cholangiogram and Common Bile Duct exploration over 14 years. An analysis of outcomes in New York State.

Maria Altieri, MD, Jie Yang, PhD, Chencan Zhu, MS, Nabeel Obeid, MD, Andrew Bates, MD, Mark Talamini, MD, Aurora Pryor, MD. Stony Brook Medical Center

Since the introduction of laparoscopy, laparoscopic cholecystectomy (LC) has become the most commonly performed general surgical procedure. Whereas during open cholecystectomy intra-operative cholangiogram (IOC) and common bile duct (CBD) exploration are easily performed, these techniques are more intricate during laparoscopy. These procedures can identify and possibly prevent CBD injury, which is a dreaded complication The purpose of our study was to evaluate the trend of IOC/CBD exploration and CBD injury during LC for benign disease.

A state-wide database (SPARCS) was used to identify all LC for benign biliary non-obstructive and obstructive disease between 2000-2014 in the state of New York. ICD-9 and CPT codes were used to identify IOC/CBD exploration and CBD injury. Multivariable logistic regression models were used in examining the linear trend in the risk of complication, readmission, and ED visits among all cholangiogram patients after controlling for possible confounding factors that were significantly associated based on chi-square tests. In these multivariable regression models any comorbidity/complication was used instead of specific ones because of limited number of events. Over the same time period, the trend in CBD injury was examined.

A total of 392,485 patients underwent LC during 2000-2014: 195,423(49.7%) inpatients and 197,062(50.2%) outpatients. The trend of IOC/CBD exploration performed between 2000-2014 significantly decreased for LC overall and particularly in the outpatient setting (11.87% to 10/27%, p<0.001). Overall complication rate, 30-day readmission rate and 30-day ED visit rates increased. When looking at overall complication rate, there was an increase by about 4 percent per year (relative risk=1.0440, p-value<.0001), as complication rate was 5.66% in 2000 and 9.62% in 2014. After controlling for confounding factors such as age, gender, race, region, insurance, inpatient, any comorbidity and any complication (not included for complication risk), their complication risk and 30-day ED visit risk increased through years, while the 30-day readmission risk did not have significant change. During 2000-2014, after controlling for aforementioned confounding factors, the non-admitted ED visit rate increased while the readmission rate did not change significantly. Hospital length of stay (HLOS) for patients with IOC/CBD decreased in this time period. Risk of CBD injury also increased significantly (p=0.04) (Figure 1).

In an era of laparoscopy, the rate of IOC/CBD exploration during LC has significantly decreased. In addition, the rate of complications and 30-day ED visits increased, although HLOS showed a decreasing trend. There is an increase in CBD injury in patients with and without IOC/CBD being performed.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 79877

Program Number: S012

Presentation Session: Biliary

Presentation Type: Podium

19

Share this:

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

Related

« Return to SAGES 2017 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