Help
Subscribe


All of GastroHep is now free access! - Click here to register Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Cholecystectomy with intraoperative cholagniography and risk of common duct injury

This week's issue of the Journal of the American Medical Association investigates the association between cholecystectomy with and without intraoperative cholangiography and risk of common duct injury.

News image

Significant controversy exists regarding routine intraoperative cholangiography in preventing common duct injury during cholecystectomy.

Dr Kristin Sheffield and colleagues from Texas, USA investigated the association between intraoperative cholangiography use during cholecystectomy and common duct injury.

Retrospective cohort study of all Texas Medicare claims data from 2000 through 2009.

The researchers identified Medicare beneficiaries 66 years or older who underwent inpatient or outpatient cholecystectomy for biliary colic or biliary dyskinesia, acute cholecystitis, or chronic cholecystitis.

The team compared results from multilevel logistic regression models to the instrumental variable analyses.

40% underwent concurrent intraoperative cholangiography
Journal of the American Medical Assocation

Intraoperative cholangiography use during cholecystectomy was determined at the level of the patients, hospitals, and surgeons.

Percentage of use at the hospital and percentage of use by surgeon were the instrumental variables.

The research team's main outcomes included patients with claims for common duct repair operations within 1 year of cholecystectomy who were considered as having major common duct injury.

Of 92,932 patients undergoing cholecystectomy, 40% underwent concurrent intraoperative cholangiography, and less than 1% had a common duct injury.

The common duct injury rate was 0.2% among patients with intraoperative cholangiography, and 0.4% among patients without it.

In a logistic regression model controlling for patient, surgeon, and hospital characteristics, the odds of common duct injury for cholecystectomies performed without intraoperative cholangiography were increased compared with those performed with it.

When confounding was controlled with instrumental variable analysis, the association between cholecystectomy performed without intraoperative cholangiography and duct injury was no longer significant.

Dr Sheffield's team concludes, "When confounders were controlled with instrumental variable analysis, there was no statistically significant association between intraoperative cholangiography and common duct injury."

"Intraoperative cholangiography is not effective as a preventive strategy against common duct injury during cholecystectomy."

JAMA 2013;310(8): 812-820
29 August 2013

Go to top of page Email this page Email this page to a colleague

 03 July 2015

Advanced search
 03 July 2015 
Tumors with mismatch-repair deficiency
 03 July 2015 
Aptitude of trainees in endoscopic ultrasonography
 03 July 2015 
Extracolonic pathologies in colorectal cancer
 02 July 2015 
Ulcerative colitis prognosis after thiopurines withdrawal
 02 July 2015 
Health care use by IBD children
 02 July 2015 
Anastomotic leak and cancer cancer
 01 July 2015 
Oral mechanical bowel preparation
 01 July 2015 
Missed gastric cancers
 01 July 2015 
Probiotics in IBD
 30 June 2015 
Split-dose preparations vs day-before bowel cleansing regimens
 30 June 2015 
Glucocorticoids and peptic ulcer bleeding
 30 June 2015 
NSAIDs and hearburn symptoms
 29 June 2015 
Prevention of pancreatitis after ERCP
 29 June 2015 
Advances in autoimmune pancreatitis
 29 June 2015 
Rescue therapy in ulcerative colitis
 26 June 2015 

Gene polymorphism in alcoholic liver disease

 26 June 2015 
Dietary fibre–microbiota interactions
 26 June 2015 
Gastritis in celiac disease
 25 June 2015 
Persistent organ failure in acute cholangitis patients
 25 June 2015 
Vitamin D level and primary biliary cirrhosis
 25 June 2015 
Fecal microbiota in pediatric IBD
 24 June 2015 
Fatigue scales for IBD
 24 June 2015 
Mucosal healing tests in ulcerative colitis
 24 June 2015 
Environmental risk in IBD
 23 June 2015 
Marker associated with endoscopic lesion in Crohn's
 23 June 2015 
Body composition in children with IBD
 23 June 2015 
Medical vs nurse endoscopists
 22 June 2015 
Gene polymorphism associated with increased liver enzymes
 22 June 2015 
Treatment of uncomplicated acute appendicitis
 22 June 2015 
Solid organ cancers after liver transplant
 19 June 2015 
Causes of death in HBV
 19 June 2015 
Lifetime benefits of increased adenoma detection rates
 19 June 2015 
Acid-suppressive therapy before anti-reflux surgery
 18 June 2015 
Risk for dyspepsia
 18 June 2015 
Endoscopic activity in symptomatic IBD patients
 18 June 2015 
Regimens for H. pylori eradication
 17 June 2015 
NAFLD risk in celiac disease
 17 June 2015 
Non-invasive markers of advanced liver fibrosis
 17 June 2015 
Patients’ and clinicians’ perception of pouch dysfunction
 16 June 2015 
Risk score for hepatocellular carcinoma screening
 16 June 2015 
Esophageal food bolus impaction
 16 June 2015 
Evaluating lymph node metastasis for rectal cancer
 15 June 2015 
Low-cost colonoscopy training
 15 June 2015 
Determining dysbiosis in IBS or IBD
 15 June 2015 
Light alcohol consumption and NAFLD
 12 June 2015 
Smoking and disease course in IBD
 12 June 2015 
Hep D in a Hep B endemic area
 12 June 2015 
Patient-orientated internet information in ulcerative colitis
 11 June 2015 
Physical inactivity and NAFLD
 11 June 2015 
Esophageal stricture after endoscopic resection
 11 June 2015 
Guideline based screening strategies for hepatitis
 10 June 2015 
Cost-effectiveness of HCV treatment in liver disease
 10 June 2015 
Abdominoperineal excision for low rectal cancer
 10 June 2015 
Pediatric chronic Hep C
 09 June 2015 
Bile acid malabsorption in IBS
 09 June 2015 
Racial differences in celiac disease
 09 June 2015 
Conversion from laparoscopic to open colorectal cancer resection
 08 June 2015 
Short sleep duration and NAFLD
 08 June 2015 
Heritability in inflammatory bowel disease
 08 June 2015 
Eosinophilic esophagitis

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2015 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us