The tangible consequences and intangible implications of laparoscopic cholecystectomy-associated bile duct injuries

When laparoscopic cholecystectomy (LC) was introduced more than two decades ago, alarming rates of bile duct injuries (BDIs) occurred in up to 0.4% of operations, twice as often as with open cholecystectomy, with only a recent decrease in incidence.1 Three contemporary studies from the National Health Service database in the UK and two statewide databases in the USA (New York and California), report laparoscopic cholecystectomy bile duct injury (LC-BDI) rates between 0.08–0.22%, which are comparable to open cholecystectomy, but these estimations may not accurately represent the true incidence of BDIs elsewhere.2-4