{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:28:24Z","timestamp":1777447704688,"version":"3.51.4"},"reference-count":21,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2022,2,16]],"date-time":"2022-02-16T00:00:00Z","timestamp":1644969600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Aim is to evaluate geographical and demographic factors influencing management of bile duct injuries occurring during cholecystectomy in a tertiary hepato-pancreato-biliary center in Southeast US.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All referrals for biliary injuries during cholecystectomy, between Jan 2017 and December 2020 were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>19 patients were identified with a median age of 59 (47-65), average BMI of 30.3 (18-49), and the prevalence of diabetes mellitus, hypertension and cardiovascular disease of 11%, 47% and 16%, respectively. The average transfer distance was 76 miles (8-102) and median transfer time was 3\u00a0days (1-12). 16 (84%) had Strasberg E injury, with 4 (21%) having a concomitant vascular injury (3 - right hepatic artery, 1 - right portal vein). Two (10.5%) were managed non-operatively, immediate surgical repair was performed in 2 (10.5%) and 15 (78.9%) patients underwent a delayed repair with a median of 87\u00a0days (69-118) from injury to repair. Median operative time was 5\u00a0hours (4-7), blood loss was 150\u00a0mL (100-200) and hospital stay was 8\u00a0days (6-12).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Factors including distance between hospitals, delays in patient transfer due to bed availability and transportation, play a role in the decision-making towards delayed repair. The delayed repair has the benefit of medical optimization of our high-risk patients\u2019 population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348211063553","type":"journal-article","created":{"date-parts":[[2022,2,16]],"date-time":"2022-02-16T21:11:11Z","timestamp":1645045871000},"page":"1749-1753","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Management of Major Injuries to the Bile Duct at a Hepatobiliary Specialty Referral Center"],"prefix":"10.1177","volume":"89","author":[{"given":"Alex","family":"Zendel","sequence":"first","affiliation":[{"name":"University of North Carlina at Chapel Hill School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aman","family":"Kumar","sequence":"additional","affiliation":[{"name":"University of North Carlina at Chapel Hill School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pablo","family":"Serrano","sequence":"additional","affiliation":[{"name":"University of North Carlina at Chapel Hill School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guilherme C.","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"University of North Carlina at Chapel Hill School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Button","sequence":"additional","affiliation":[{"name":"University of North Carlina at Chapel Hill School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Betelhme","family":"Gebre","sequence":"additional","affiliation":[{"name":"University of North Carlina at Chapel Hill School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David A.","family":"Gerber","sequence":"additional","affiliation":[{"name":"University of North Carlina at Chapel Hill School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chirag S.","family":"Desai","sequence":"additional","affiliation":[{"name":"University of North Carlina at Chapel Hill School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,2,16]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2010.04.003"},{"key":"e_1_3_2_3_2","first-page":"101","article-title":"An analysis of the problem of biliary injury during laparoscopic cholecystectomy","volume":"180","author":"Strasberg SM","year":"1995","unstructured":"Strasberg SM, Hertl M, Soper NJ. An analysis of the problem of biliary injury during laparoscopic cholecystectomy. J Am Coll Surg. 1995;180:101-125.","journal-title":"J Am Coll Surg"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-015-4609-8"},{"key":"e_1_3_2_5_2","first-page":"571","article-title":"Bile duct injury during laparoscopic cholecystectomy: A prospective nationwide series","volume":"184","author":"Adamsen S","year":"1997","unstructured":"Adamsen S, Hansen OH, Funch-Jensen P, Schulze S, Stage JG, Wara P. Bile duct injury during laparoscopic cholecystectomy: A prospective nationwide series. J Am Coll Surg. 1997;184:571-578.","journal-title":"J Am Coll Surg"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/hpb.12374"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199308000-00003"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-016-3677-9"},{"key":"e_1_3_2_9_2","volume-title":"Long-term Impact of Bile Duct Injury on Morbidity, Mortality, Quality of Life, and Work Related Limitations","author":"Booij KAC","year":"2017","unstructured":"Booij KAC, de Reuver PR, van Dieren S, et al. Long-term Impact of Bile Duct Injury on Morbidity, Mortality, Quality of Life, and Work Related Limitations. Ann Surg; 2017."},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2013.01.051"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hpb.2016.06.016"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/155335069800500209"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003448"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001868"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.5194"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2012.01.054"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1477-2574.2010.00225.x"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2007.07.008"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.suc.2014.01.008"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000252442.91839.44"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2009.07.038"},{"key":"e_1_3_2_22_2","doi-asserted-by":"crossref","unstructured":"Schmidt CS Settmacher U Langrehr JM Neuhaus P. Management and outcome of patients with combined bile duct and hepatic arterial injuries after laparoscopic cholecystectomy. Surgery 2004; 135(6):613\u2013618.","DOI":"10.1016\/j.surg.2003.11.018"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348211063553","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348211063553","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348211063553","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:35:24Z","timestamp":1777379724000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348211063553"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,16]]},"references-count":21,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,5]]}},"alternative-id":["10.1177\/00031348211063553"],"URL":"https:\/\/doi.org\/10.1177\/00031348211063553","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,16]]}}}