TY - CHAP M1 - Book, Section TI - Chapter 53A. Perspective on Biliary Surgery A1 - Hanto, Douglas W. A2 - Zinner, Michael J. A2 - Ashley, Stanley W. PY - 2013 T2 - Maingot's Abdominal Operations, 12e AB - There is little question that laparoscopic surgery in general surgery has had the greatest impact in the treatment of cholelithiasis and cholecystitis with over 80% of cholecystectomies being performed laparoscopically and laparoscopic cholecystectomy being one of the most common general surgical procedures performed. Although laparoscopic cholecystectomy has led to more frequent surgical treatment of gallbladder disease and a reduction in postoperative pain and hospital stay, as well as earlier return of bowel function and full activity, and decreased cost, it has not led to a reduction in the incidence of common bile duct (CBD) injuries. The most recent data cite an estimated incidence of 0.4–1.3% bile duct injuries after laparoscopic cholecystectomy compared to 0.2% after open cholecystectomy with significant patient morbidity and a high risk of litigation.1,2 It has always seemed odd that, faced with a bile duct injury, no more than 15% of surgeons refer these patients to subspecialty hepatobiliary surgeons for repair.3 The risk of bile duct injury had been thought to be greater earlier in a surgeon's experience with a 1.7% incidence of bile duct injury in the first case and a 0.17% chance of bile duct injury in the 50th case.4 However, other studies have shown that there is no reduction in risk as surgeons do more cases.2,5 SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/10/12 UR - accesssurgery.mhmedical.com/content.aspx?aid=57019163 ER -