“Will You Take My Picture?”
Over 600,000 people per year in the U.S. have high tech gallbladder surgery with a scope (known as a laparoscope). It is a relatively safe procedure, but there is one SERIOUS complication you need to be aware of.
One of the most devastating injuries that can occur during gallbladder surgery is the surgeon cutting the patient’s common bile duct, which serves as the “highway” for transporting bile between the liver and the stomach. This is a major mistake, and signifies that the surgeon has cut the common bile duct instead of the cystic duct. The cystic duct, which is the “exit ramp” on the duct highway and which connects to the gallbladder, should be cut. The common bile duct – the main highway – should NEVER be cut or damaged. Common bile duct injuries require major reconstructive surgery and can cripple a person’s ability to move bile, which can damage or even ruin the liver.
There is a valuable tool for identifying the anatomy of the bile duct system, particularly the differences between the common bile duct and the cystic duct. It is called a cholangiogram, which is simply an x-ray exam of the bile ducts taken during surgery after dye is injected into the duct. The purpose of this simple x-ray is to help the surgeon identify the bile duct anatomy before anything is cut or removed, and it will even show if a patient’s bile duct anatomy is different than normal.
So, if you are having laparoscopic gallbladder surgery, you should ask your surgeon: “If there is any doubt in your mind as to what you are cutting, will you take an x-ray picture to make sure before anything is cut?”
Although most surgeons do not perform cholangiograms in every surgery, they SHOULD perform one (it takes about 20 minutes) if they are not completely sure of the anatomy of the bile duct system. Any good surgeon should be willing to explain under what circumstances he or she will use a cholangiogram or take other safety steps to avoid a devastating common bile duct injury. And if the surgeon is put off or offended by your question and your medical knowledge, get another surgeon!