Resident's Forum
August 2010

Asian Race/Ethnicity as a Risk Factor for Bile Duct Injury During Cholecystectomy

Author Affiliations

RICHARD D.SCHULICKMDPAMELA A.LIPSETTMDAuthor Affiliations: Departments of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland (Drs Downing, Chang, and Ahuja and Ms Datoo); and College of Medicine, Howard University, Washington, DC (Drs Downing, Oyetunji, Fullum, and Chang).


Copyright 2010 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2010

Arch Surg. 2010;145(8):785-787. doi:10.1001/archsurg.2010.131

Iatrogenic bile duct injury (BDI) is an uncommon but serious complication of cholecystectomy, with identified risk factors of acute cholecystitis, male sex, older age, and aberrant biliary anatomy. The Nationwide Inpatient Sample (1998-2006) was queried for cholecystectomy performed on hospital day 0 or 1. Bile duct injury repair procedure codes were used as a surrogate for BDI. We identified 377 424 patients who underwent cholecystectomy, with 1124 BDIs (0.3%). On multivariate logistic regression analysis, Asian race/ethnicity was a significant risk factor for BDI (odds ratio [OR], 2.26; 95% confidence interval [CI], 1.59-3.23; P < .001). This persisted for laparoscopic (OR, 2.62; 95% CI, 1.28-5.39; P = .009) and open (2.21; 1.59-3.07; P < .001) cholecystectomies. No other race/ethnicity was identified as a risk factor for BDI. We report a new finding that Asian race/ethnicity is a significant risk factor for BDI in laparoscopic and open cholecystectomies.