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  - 2024/04/19
UR  - accesssurgery.mhmedical.com/content.aspx?aid=57019163
ER  -