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Gallbladder Surgery Errors Damage Bile Duct

X-ray Procedures Can Reduce Gallstone Surgery Error Rates

An estimated 750,000 gallbladder surgeries are performed a year to treat serious gallstone problems. As many as one in every 200 patients suffers bile-duct injury. The modern laparoscopic surgery that is performed results in two to ten times as many bile duct injuries as tradtional surgery.

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Botched gallbladder surgeries are a leading cause of malpractice claims and are more likely to be settled in favor of plantiffs. The average settlement award is approximately $250,000. On average, half of all surgeons performing these operations will mistakenly cut the bile duct at least once in their career. The bile duct is cut so often because surgeons mistake it for the nearby cystic duct which must be severed to remove the gallbladder. When the bile duct is cut, bile leaks into the abdomin causing an infection. Repairing the bile duct requires major reconstructive surgery and an extended hospital stay.

Guidelines promoted by the Society of American Gastrointestinal and Endoscopic Surgeons recommend that intraoperative cholangiograms, an X-ray procdure, "be applied liberally" before surgery to help the surgeon identify sensitive anatomy. A review of scientific research published in March, 2007 in the Journal of American College of Surgeons reinforces this recommendation. Pre-surgery cholangiogram procedures cost between $100 and $200, take ten minutes, and afford the surgeon better awareness of what anatomy requires excision. Several studies demonstrate value of X-ray Cholangiogram. A 2002 German study of 300,000 gallbladder operations demonstrated that bile duct injuries were cut in half when cholangiograms were performed. A Medicare study of 1,600,000 gallbladder operations found the bile duct injury rate was 40% lower when pre-surgery X-rays were taken. A 2003 UC San Francisco study of 252 gallbladder operations determined that nearly every injury was the result of surgeons believing purposely cutting what they believed was the correct duct.

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