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Introduction:The Philippine Association of Laparoscopic and Endoscopic
Surgeons (PALES) initiated the Zero BDI Campaign in 2017 to prevent bile duct
injury (BDI) during laparoscopic cholecystectomy (LC). We aim to evaluate the
effect of the campaign in preventing BDI among general surgeons performing LC
and describe the contributing factors, types and management of BDI.
Methodology: This is a cross-sectional study conducted during the PALES 2020:
Virtual Congress through an electronic survey. Data were gathered using Microsoft
Excel. Statistical analysis was done using EPI info version 6.
Results: Two hundred ninety-eight (84.9%) out of responses 351 were
included. Among them, 57 (19.13 %) surgeons reported a total of 103 BDI. 51
(17.11%) respondents had a 82 BDI before the campaign, and 16 (5.37%) surgeons
reported BDI in 21 LC cases after the campaign. Among the surgeons who reported
BDI, 45 (78.95%) of them had injury in acute cholecystitis, 12 (21.05%) in chronic
cholecystitis and none in asymptomatic cholelithiasis. Those with BDI, 14 (24.56
%) were referred to another surgeon for repair, 14 (24.56 %) were converted to
open repair over T-tube and 13 (22.81 %) were converted to open biliary
reconstruction and a few performed laparoscopic intervention. Surgeons who
performed more than 100 LC annually were 5.39 times more likely to have BDI.
Conversion to open cholecystectomy, operative time and technique used to identify
the Triangle of Calot were not associated with higher risk of BDI.
Conclusion: There was a clinical decrease in incidence of BDI during LC after the
PALES 2020 – Zero BDI Campaign was introduced.