Native Americans Have an Increased Risk of Major Bile Duct Injury during Laparoscopic Cholecystectomy: Results from a Statewide Analysis

摘要

Over 2.1 million Native Americans (NA) reside in the United States and 5.2 million people identify as NA in combination with other ethnicities. NA population numbers were noted to increase 18 per cent from 2000 to 2010. Recent studies have revealed significant health disparities and inferior surgical outcomes in this small but growing U.S ethnic minority.1 The high incidence of both benign and malignant gallbladder disease in NA populations, specifically those living in the southwest United States, is widely known. Studies performed before the laparoscopic era suggested that NA may experience increased postoperative complications after cholecystectomy compared to non-Hispanic Whites (NHW), though rates of bile duct injury (BDI) were not examined during this time.2 Major BDI presents a rare though devastating complication of laparoscopic cholecystectomy (LC). The presence of acute cholecystitis, male sex, aberrant biliary anatomy, and older age are associated with an increased risk of BDI during LC. One study to date has explored ethnicity as a possible risk factor for BDI. NA were not analyzed as a separated ethnic group and their BDI risk remains unknown.