Analysis of risk factors for bile duct injury in laparoscopic cholecystectomy in China: A systematic review and meta-analysis

Abstract

Background: To explore the risk factors of bile duct injury in laparoscopic cholecystectomy (LC) in China through meta-analysis. Methods: The study commenced with a search and selection of case–control studies on the risk factors for bile duct injury in LC in China using the following databases: PubMed, EMBASE, ScienceNet.cn, CNKI, Wanfang Data, and VIP. Data were extracted from the collected documents independently by 2 researchers, following which a meta-analysis of these data was performed using Revman 5.3. Results: The compilation of all data from a total of 19 case–control studies revealed that among 41,044 patients, 458 patients experienced bile duct injury in LC, accounting for the incidence rate of 1.12% for bile duct injury. The revealed risk factors for bile duct injury were age (≥40 years) (odds ratio [OR] = 6.23, 95% CI [95% confidence interval]: 3.42–11.33, P < .001), abnormal preoperative liver function (OR = 2.01, 95% CI: 1.50–2.70, P < .001), acute and subacute inflammation of gallbladder (OR = 8.35, 95% CI: 5.32–13.10, P < .001; OR = 4.26, 95% CI: 2.73–6.65, P < .001), thickening of gallbladder wall (≥4 mm) (OR = 3.18, 95% CI: 2.34–4.34, P < .001), cholecystolithiasis complicated with effusion (OR = 3.05, 95% CI: 1.39–6.71, P = .006), and the anatomic variations of the gallbladder triangle (OR = 11.82, 95% CI: 6.32–22.09, P < .001). However, the factors of gender and overweight (body mass index ≥ 25 kg/m 2 ) were not significantly correlated with bile duct injury in LC. Conclusions: In the present study, age (≥40 years), abnormal preoperative liver function, gallbladder wall thickening, acute and subacute inflammation of the gallbladder, cholecystolithiasis complicated with effusion, and anatomic variations of the gallbladder triangle were found to be closely associated with bile duct injury in LC.

Complete Common Bile Duct Injury after Laparoscopic Cholecystectomy in Situs Inversus Totalis: A Case Report, Review of the Literature and Illustrative Case Video

“…The reported incidence of iatrogenic BDI in patients undergoing laparoscopic cholecystectomy ranges between 0.07 and 1.1 % in the literature [ 11 , 12 ]. While there is no evidence to suggest that SIT increases the risk of BDI following laparoscopic cholecystectomy [ 13 ], the anatomical variation associated with SIT is a potential risk factor that may contribute to a higher incidence of BDI after the procedure [ 14 , 15 ]. Furthermore, several other factors may contribute to an increased risk of BDI in patients with SIT: A delay in the diagnosis and management of gallbladder disease can occur if the patient's SIT status is unknown beforehand [ 3 ].…”

Avoidance of bile duct injury in laparoscopic cholecystectomy with feasible intraoperative resources: A cohort study

“…According to a systematic review and meta-analysis in China, the incidence rate of BDI was 1.12% (16). In a large study in India (17), it was 0.05%, and in a local study (Sulaimani, Kurdistan region, Iraq) (18), it was 0.4%.…”

“…In a study conducted by Reinsoo et al ( 15 ) over 11 years, 241 BDIs were reported among 29,739 LCs (0.81%): 0.68% were minor injuries and 0.13% were major injuries. According to a systematic review and meta-analysis in China, the incidence rate of BDI was 1.12% ( 16 ). In a large study in India ( 17 ), it was 0.05%, and in a local study (Sulaimani, Kurdistan region, Iraq) ( 18 ), it was 0.4%.…”

Predective Factors of Common Bile Duct Injury in Laparoscopic Cholecystectomy

“…In light of the intricate nature and heightened potential for postoperative complications, it is common practice to circumvent such issues whenever feasible (16) . Yang et al (17) reported that the revealed risk factors for bile duct injury were abnormal preoperative liver function, acute and subacute inflammation of gallbladder, thickening of gallbladder wall (≥4 mm), cholecystolithiasis complicated with effusion, and the anatomic variations of the gallbladder triangle. However, the factors of gender and overweight (body mass index ≥ 25 kg/m 2 ) were not significantly correlated with bile duct injury in LC.…”