Incidencia de lesión de vías biliares en un hospital universitario: análisis de más de 1.600 colecistectomías laparoscópicas

Abstract

Introduction. Laparoscopic cholecystectomy is the most common laparoscopic procedure performed by the general surgeon. Bile duct injury (BDI) is the most feared complication due to its clinical and economic implications. The goal of this study was to determine the incidence of BDI at a teaching hospital and to identify possible related risk factors. Methods. This is an observational retrospective study that included patients who underwent laparoscopic cholecystectomy at San Vicente Foundation University Hospital (HUSVF) in Medellin, Colombia, in the period 2011 to September 2016. Univariate and bivariate analyses were performed to explore possible association of some perioperative variables with BDI. Statistic software STATA 2014 was used. Results. A total of 1,601 patients were included. BDI incidence was 0.8% (14 patients), global mortality was 0.4%. Most of BDIs were type A of the Strasberg classification and only two patients required complex reconstructions of the bile ducts. Longer operative time (p>0.05) and higher intraoperative blood loss (p<0.05) were related with BDI. Conclusion. Laparoscopic cholecystectomy is a safe procedure at HUSVF, a training center for surgical residents. Bile duct injury rate at this hospital is similar to that reported in the literature.