Instilling a culture of safety for laparoscopic cholecystectomy

  • Jake E J Krige University of Cape Town
  • E Jonas University of Cape Town
  • S Hofmeyr Stellenbosch University

Abstract

Laparoscopic cholecystectomy (LC) is the preferred and most widely used method for removal of the gallbladder in patients with symptomatic cholelithiasis. Modern laparoscopic equipment provides better illumination and definition with the most recent generation processors and cameras offering the possibility of 3D visualization. The minimal access approach results in smaller wounds, less postoperative pain, faster recovery, shorter hospital stay and ultimately a better cosmetic result.1 The major disadvantage of LC, however, is the biliary complications associated with the procedure, the most serious of which is a major bile duct injury (BDI).2 Although the technique was introduced more than two decades ago, the incidence of BDIs has not decreased and still occurs in 0.4% of operations, a figure twice as high as recorded during the era of open cholecystectomy.3 A recent Swedish population-based study reporting a BDI rate of 1.5% suggests that the rates in the literature may be an underestimation, or more alarmingly, that BDI rates are increasing.4

Author Biographies

Jake E J Krige, University of Cape Town

Department of Surgery
University of Cape Town
Health Sciences Faculty
Surgical Gastroenterology and HPB Unit
Groote Schuur Hospital
Observatory
Cape Town
South Africa

E Jonas, University of Cape Town

Department of Surgery
University of Cape Town
Health Sciences Faculty
Surgical Gastroenterology and HPB Unit
Groote Schuur Hospital
Observatory
Cape Town
South Africa

S Hofmeyr, Stellenbosch University
Division of Surgery
University of Stellenbosch
Faculty of Medicine and Health Sciences
Surgical Gastroenterology Unit
Tygerberg Academic Hospital
Published
2016-11-23
How to Cite
Krige, J., Jonas, E., & Hofmeyr, S. (2016). Instilling a culture of safety for laparoscopic cholecystectomy. South African Journal of Surgery, 54(3), 2-5. Retrieved from http://sajs.redbricklibrary.com/index.php/sajs/article/view/2078
Section
Editorial