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Multi-Society BDI Consensus ConferenceMulti-Society BDI Consensus Conference

Preventing Bile Duct Injuries - Safe Cholecystectomy

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Agenda

Meeting Rooms

REGISTRATION: Seaport Ballroom Foyer
SCIENTIFIC SESSION:  Seaport Ballroom
LUNCH: Plaza Ballroom AB (Plaza Level)

Download Printable Agenda
Saturday, October 20, 2018
7:00am – 4:45pm Registration
7:30am – 8:00am Continental Breakfast
8:00am – 8:10am Introduction and goals for the consensus conference
Presenter: Michael Brunt, MD
8:10am – 8:25am Overview of laparoscopic cholecystectomy and BDI as a public health problem
Presenter: Dana Telem, MD
8:25am – 8:40am Overview of key PICO (Population, Intervention, Comparator, Outcome) questions on BDI prevention
Presenter: Steven Strasberg, MD
8:40am – 8:50am Description of the methodology used to frame and answer the key questions
Presenter: Mohammed Ansari, MD MMedSC MPhil
8:50am – 9:00am Description of the methodology for conducting the consensus conference meeting and gaining expert consensus on the key questions for which there are poor or little data
Presenter: Dimitrios Stefanidis, MD
Presentations and review of the literature findings and recommendations for key questions. Each section will include:

  • Summary of relevant literature review and consensus recommendations
  • Discussion and audience response with voting
  • Discussion of gaps and future steps
9:00am – 10:00am BDI Prevention and Anatomic Identification
Presenters: Daniel Deziel, MD, Marian McDonald, MD, and Maria Altieri, MD

  • PICO 1. Should one technique of anatomical identification (critical view of safety) versus another be used for limiting the risk or severity of bile duct injury in patients undergoing laparoscopic cholecystectomy?
  • PICO 2. Should the top-down technique of complete cholecystectomy versus subtotal cholecystectomy be used for limiting the risk or severity of bile duct injury when the critical view of safety cannot be achieved?
  • PICO 3. Should requirements for one type of documentation of the critical view of safety (photos) versus another (operative notes or video) are no documentation requirement be used for limiting the risk of severity of bile duct injury during cholecystectomy?)
10:00am – 10:15am Break
10:15am – 11:10am Imaging and Prevention of Biliary Injury
Presenters: Michael Brunt, MD, Adnan Alseidi, MD, and Michael Ujiki, MD

  • PICO 4. Should intraoperative biliary imaging (cholangiography, ultrasound, infrared cholangiography close) versus no imaging be used for limiting the risk or severity of bile duct injury during cholecystectomy?
  • PICO 5. Should one type of intraoperative biliary imaging versus alternative biliary imaging be used for limiting the risk or severity of bile duct injury during cholecystectomy?
11:10am – 12:10pm Biliary Injury and Disease Factors
Presenters: Taylor Riall, MD and Dana Telem, MD

  • PICO 6. Should surgical (complexity) risk stratification (risk factors or risk prediction models) guided surgery vs alternative risk stratification or no risk stratification guided surgery be used for limiting the risk or severity of bile duct injury in candidates for cholecystectomy?
  • PICO 7. Should surgery guided by prior risk stratification that accounts for cholecystolithiasis vs no risk stratification or alternative risk stratification be used?
  • PICO 9. Should subtotal cholecystectomy vs total laparoscopic or open cholecystectomy be used for limiting the risk or severity of bile duct injury in patients who at the time of their operation have marked acute local inflammation or chronic cholecystitis with biliary inflammatory fusion (BIF) of tissues and tissue contraction?
12:10pm – 1:00pm Lunch
1:00pm – 1:50pm Biliary Injury and Disease Factors
Presenters: Steven Strasberg, MD and Chet Hammill, MD

  • PICO 8. Should immediate cholecystectomy (within 72 hrs from symptom onset) vs cholecystectomy delayed beyond 72 hours (but <10 days from symptom onset) vs cholecystectomy delayed beyond 6 weeks vs cholecystectomy delayed beyond 12 weeks be used for patients with acute cholecystitis?
  • PICO 11. Should interval/delayed laparoscopic cholecystectomy vs no additional treatment be used for patients previously treated by cholecystostomy and high co-morbidity score (Charleson 6 or>ASA3/ASA4)?
1:50pm – 2:30pm Biliary Injury and Surgeon Factors
Presenter: Carol-Anne Moulton, MD

  • PICO 10. Should standard 4-port lap cholecystectomy vs SILS laparoscopic cholecystectomy vs robotic cholecystectomy vs open cholecystectomy vs other technique be used for limiting the risk or severity of bile duct injury in candidates for cholecystectomy?
  • PICO 12. Should conversion of laparoscopic cholecystectomy to open cholecystectomy vs no conversion be used for limiting the risk or severity of bile duct injury during difficult laparoscopic cholecystectomy?
  • PICO 13. Should surgeons taking a time out to verify the critical view of safety vs no time out be used for limiting the risk or severity of bile duct injury?
  • PICO 14. Should two surgeons vs one surgeon be used for limiting the risk or severity of bile duct injury?
2:30pm – 3:00pm Management of Acute BDI
Presenters: Horacio Asbun, MD, Rowan Parks, MD and Jaap Bonjer, MD

  • PICO 18. Should immediate reconstruction by the operating surgeon vs referral to a specialty center be used for patients with bile duct injury during laparoscopic cholecystectomy?
3:00pm – 3:15pm Break
3:15pm – 4:00pm Education and Training
Presenter: Rajesh Aggarwal, MD

  • PICO 15. Should critical view of safety coaching of surgeon vs no specific critical view of safety coaching be used for limiting the risk or severity of bile duct injury?
  • PICO 16. Should training of surgeons by simulation method or video-based education vs alternatively surgeon training be used for limiting the risk or severity of bile duct injury?
  • PICO 17. Should more surgeon experience vs less surgeon experience be used for limiting the risk or severity of bile duct injury?
4:00pm – 4:30pm Open Panel Discussion with Audience Participation
4:30pm – 4:40pm Closing Remarks

 

Funding for this conference was made possible by 1 R13 DK 120271-01 from NIDDK. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention by trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

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