Introduction : Laparoscopic cholecystectomy (LC) is standard treatment for benign gallbladder disease. Bile duct injury is one of most concerned complication during LC However, the incidence of bile duct injury during LC has not changed significantly in the past 2 decades despite increased operative experience and technical refinement. So current study aimed to assess factors associated with bile duct injury during LC

Methods : In a prospective Korea Cholecystectomy Quality Improvement Program cohort including 18 institutions from October 2016 to March 2017, 2610 patients who underwent laparoscopic cholecystectomy for benign gallbladder disease were enrolled. Various characteristics, preoperative findings, operative findings were compared between two groups (Bile duct injury versus No injury).

Results : Among study cohort, patients with bile duct injury during LC were 17. In univariate analysis, Male sex, Emergent operation, OP difficulty score ≥3, Acute cholecystitis, GB dilatation, Difficult grasping, pericholecystic abscess are risk factor for bile duct injury. In multivariate analysis, Preoperative CBD stone(p=0.045) and pericholecystic abscess(p<0.001) are risk factor for bile duct injury.

Conclusions : Preoperative CBD stone and pericholecystic abscess is risk factor for bile duct injury during LC. If preoperative CBD stone or pericholecystic abscess is confirmed by preoperative imaging or intraoperative findings, surgeons should be done with caution.