A procedure which allows careful location of the bile duct is linked to reduced levels of bile duct injury during gall bladder surgery.
Removal of the gall bladder - cholecystectomy - is the most commonly performed elective surgical procedure in the US. Occasionally the bile duct is damaged during such surgery, and this is the leading cause of malpractice claims against surgeons. Naturally, any change in procedure that can avoid this rare complication is welcome.

Doctors at the University of Washington, Seattle, have analysed the impact of intraoperative cholangiography (IOC) during gall bladder surgery. IOC is a procedure where a contrast dye is injected to help locate the bile duct. Some surgeons always do IOC, others rarely use it. In this analysis which covered over one and a half million gall bladder operations, it was found that bile duct injury occurred in 0.39 per cent of cases where IOC was used. When it was not used, the rate was higher at 0.58 per cent.

This study does not prove that IOC in itself reduces bile duct injury. But the matter is worthy of some further investigation. The best way forward would be to carry out a controlled prospective clinical trial, where some patients had IOC and some not, to see what the outcome was.