Lap Chole's

[Noyac]

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Do the surgeons that you guys work with always do intraoperative cholangiograms when they do their lap chole's? My previous job never did them with the rare exception and my current job always does them. I asked them why and they said 5% of the stones (I assume they mean in the CBD/cystic duct) are missed. Are they not identified by CT or ultrasound? Then they started to give me the typical excuses, helps identify the anatomy (don't you know the anatomy 😱 ) and it helps with familiarity for when you really need to do one. Just curious.

 

[jetproppilot]

Do the surgeons that you guys work with always do intraoperative cholangiograms when they do their lap chole's? My previous job never did them with the rare exception and my current job always does them. I asked them why and they said 5% of the stones (I assume they mean in the CBD/cystic duct) are missed. Are they not identified by CT or ultrasound? Then they started to give me the typical excuses, helps identify the anatomy (don't you know the anatomy 😱 ) and it helps with familiarity for when you really need to do one. Just curious.

Probably C-note related, Noyac. Betcha they can charge more for IOC.

 

[Idiopathic]

Not for cholecystitis, but they should for cholelithiasis. Even with an IOC, stones are often missed, and people rarely get sicker than when they have a CBD obstruction post chole (IMHO)

 

[militarymd]

IOC every time here, but it only adds 5 minutes to the case.

 

[Noyac]

Yeah I asked about the extra C-notes and they said it wasn't much. But if it helps the hospital in the billing deptartment, i'm all for it as long as it appropriate. It adds about 10-20 mins to the case and there are not so many cases that we need to get them done fast.