Jahangir Sarwar Khan, Raheel Ahmad.
Common Bile Duct Injury in Laparoscopic Cholecystectomy: A Comparative Audit.
Ann Pak Inst Med Sci Nov ;11(4):164-7.

Background: Common Bile Duct injury (CBDI) is one of the serious complications of Laparoscopic cholecystectomy (LC). Although Common Bile Duct injury occurs more commonly in the early portion of a surgeon's learning curve, recent reports suggest that even surgeons with a great deal of experience with LC have high rates of CBD injury. Objectives: To compare the incidence of CBD injury and its management in three groups of patients undergoing LC. Study Design: Prospective Cohort study. Setting: Surgical Department, Rawalpindi Medical College and author's surgical clinic. From 1st January 1998 to 31st December 2014. Materials & Methods: Total 3000 patients of Laparoscopy Cholecystectomy were divided into 3 groups. First 1000 cases operated in Group A, next 1000 in Group B and last 1000 in Group C. Intraoperative findings with Incidence of CBD injuries and there management were compared. Parameters, including conversion rate, operative time, and complications, were also evaluated. Results: Out of 3000 patients 18 (0.6%) cases had CBD injury during LC. 14(1.4%) cases were in group A which decreased significantly to 0.3% (3 cases) and 0.1% (1 case) in Group B and Group C respectively. In 14 out of 15 (83.3%) cases identified intraoperatively repair with T-Tube was done, whereas 3 (16.7%) cases identified postoperatively were managed with choledochojejunostomy. Conclusion: In our setup incidence of CBD injury in LC is less than 1%. It has significantly decreased over period of 16 years mainly due to improved surgical skills.

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