Routine intraoperative cholangiograms

This is being suggested as a way to decrease the incidence of bile duct injuries – as this is one of the largest reasons for malpractice lawsuits within general surgery. I wonder if any of the surgeons who read this blog can comment:

Cholangiograms have a lot of potential, but “they have not been adopted as a routine part of most surgeons’ practices,” says Lawrence Way, a surgeon at the University of California San Francisco who is an expert in repairing bile-duct injuries. He says one reason for the lack of enthusiasm is that hundreds of cholangiograms would have to be performed to avoid one bile-duct injury. Some studies have suggested the cost of routine cholangiograms — about $122 by one estimate — doesn’t justify the expected benefit.

The issue highlights a bigger debate in the medical community over the cost-effectiveness of added safety measures. Even as doctors are pressured to reduce medical errors, there is counter-pressure to cut back on unnecessary procedures and justify each expense.

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