Help
Subscribe


Submit Videos to GastroHep 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

 17 September 2014

Advanced search
 17 September 2014 
Orange juice intake for bowel preparation
 17 September 2014 
Treatment of fistulising perianal Crohn's disease
 17 September 2014 
Interval colorectal cancers
 16 September 2014 
Fiber treats IBS
 16 September 2014 
Resected biliary tract cancer
 16 September 2014 
Postoperative adhesions in digestive surgery
 15 September 2014 
Fecal transplantation for C.diff infection
 15 September 2014 
Prunes and GI function
 15 September 2014 
Antidepressants for IBS
 12 September 2014 
Management of complex colon polyps
 12 September 2014 
Metabolic syndrome delays HBeAg seroclearance
 12 September 2014 
Drug-induced liver disease
 11 September 2014 
Sofosbuvir plus peginterferon/ribavirin for HCV
 11 September 2014 
Hepatobiliary cirrhosis risk after organ transplant
 11 September 2014 
Patient perceptions in celiac disease
 10 September 2014 
Adhesions in abdominal and pelvic surgery
 10 September 2014 
Acute kidney injury after colonoscopy
 10 September 2014 
Management algorithm for endoscopic mucosal resection of colonic lesions
 09 September 2014 
PPIs and spontaneous bacterial peritonitis in cirrhosis
 09 September 2014 
Neutrophil function and mortality in cirrhosis
 09 September 2014 
MELD and liver cancer survival
 08 September 2014 
Vagal nerve blockade and morbid obesity
 08 September 2014 
Comparison of diet programs in overweight and obese adults
 08 September 2014 
Long-term follow-up after bariatric surgery
 05 September 2014 
Healing rates in reflux esophagitis
 05 September 2014 
Progression of environmental enteropathy
 05 September 2014 
Diabetes and liver transplant outcomes
 04 September 2014 
Colectomy rates for refractory ulcerative colitis
 04 September 2014 
Infliximab prevents long-term Crohn’s disease recurrence
 04 September 2014 
Histological recovery with gluten-free diet in celiac disease
 03 September 2014 
Diagnosis of atrophic gastritis
 03 September 2014 
Predictors of response in Crohn's disease
 03 September 2014 
Safety of reinitiation of infliximab therapy
 02 September 2014 
SSRIs and depression in Hep C
 02 September 2014 
Bariatric surgery for obesity
 02 September 2014 
Eosinophilic esophagitis in adults
 01 September 2014 
Risks with anti-TNF in pediatric IBD
 01 September 2014 
Fecal hemoglobin and colorectal cancer screening
 01 September 2014 
Genetic variants in alcoholic liver disease
 29 August 2014 
Gluten-free diet for asymptomatic celiac disease
 29 August 2014 
NSAID-induced small intestinal injury and diaphragm disease
 29 August 2014 
Symptom evaluation in functional dyspepsia
 28 August 2014 
Predictoris of C. diff in out-patients
 28 August 2014 
Detection of gastroesophageal reflux symptoms
 28 August 2014 
Colorectal-cancer mortality after adenoma removal
 27 August 2014 
Endoscopy outcomes in community hospital vs tertiary academic centers
 27 August 2014 
UV exposure and IBD hospitalizations
 27 August 2014 
Hepatocellular carcinoma screening in liver disease
 26 August 2014 
NAFLD and gastroesophageal reflux symptoms
 26 August 2014 
Adalimumab-treated patients with ulcerative colitis
 26 August 2014 
Wound healing after abdominoperineal resection
 25 August 2014 
Surgical management of rectourethral fistulas
 25 August 2014 
Biomarker analysis in biopsies for ulcerative colitis
 25 August 2014 
Ileocolic resection in Crohn's disease
 22 August 2014 
Outlier identification in colorectal surgery
 22 August 2014 
Endoscopic submucosal dissection for squamous esophageal cancer
 22 August 2014 
Adherence to Rome criteria in functional dyspepsia trials
 21 August 2014 
Screening for Barrett’s esophagus
 21 August 2014 
Colorectal cancer mortality in Brazil
 21 August 2014 
Eosinophilic esophagitis

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2014 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us