Long-term Detrimental Effect of Bile Duct Injury on Health-Related Quality of Life

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Abstract
The field of general surgery was revolutionized in the late 1980s with the introduction of the laparoscopic cholecystectomy (LC). During the past decade, LC has become the procedure of choice for the treatment of cholelithiasis. Laparoscopy has many benefits to the patient, including less perioperative pain, improved cosmesis, decreased length of hospitalization, and earlier return to normal activities. Unfortunately, the benefits of laparoscopy do not come without the potential for great harm. The data consistently show a higher incidence of common bile duct injury (BDI) during LC when compared with open cholecystectomy, at least 0.4% vs 0.2%, respectively.1-6 Initially, the increase in common BDIs during LC was attributed to a "learning curve" for the surgeons.4 However, after a decade of experience and increased exposure of young surgeons to laparoscopy in residency programs, the injury rate has remained relatively unchanged.7