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Does A Surgeon as First Assistant Reduce the Incidence of Common Bile Duct Injuries during Laparoscopic Cholecystectomy?

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Abstract:

This retrospective review supports the hypothesis that a surgeon acting as first assistant during laparoscopic cholecystectomy will reduce the incidence of significant common bile duct (CBD) injuries (BDIs). Central Carolina Surgery, P.A., is a single-specialty general surgery group of 19 surgeons that have performed 8767 laparoscopic cholecystectomies from October 1999 to December 2007. In those cases, 89 per cent of the cases had surgeons as first assistants and 66 per cent of the cases were performed with intraoperative cholangiography. Five cases of BDI occurred during this period for an incidence of 0.0570 per cent. Only three of these injuries required bilioenteric anastomotic reconstruction. When this same group of surgeons learned to perform laparoscopic cholecystectomy in 1990, their published series (Surgical Endoscopy: [1993] 7: 300 to 303] of 762 cases had 98 per cent of cases performed with a surgeon as first assistant and no CBD injuries. Only 27 per cent of those 762 cases had intraoperative cholangiograms. This single-practice general surgery experience supports the use of a surgeon as first assistant to lower the incidence of CBD injures.

Document Type: Research Article

Affiliations: From Central Carolina Surgery, P.A., Greensboro, North Carolina, USA

Publication date: 2010-03-01

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  • The Southeastern Surgical Congress owns and publishes The American Surgeon monthly. It is the official journal of the Congress and the Southern California Chapter of the American College of Surgeons, which all members receive each month. The journal brings up to date clinical advances in surgical knowledge in a popular reference format. In addition to publishing papers presented at the annual meetings of the associated organizations, the journal publishes selected unsolicited manuscripts. If you have a manuscript you'd like to see published in The American Surgeon select "Information for Authors" from the Related Information options below. A Copyright Release Form must accompany all manuscripts submitted.
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