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Comment & Response |

Intraoperative Cholangiography During Cholecystectomy

David Reed Flum, MD, MPH1
[+] Author Affiliations
1Department of Surgery, University of Washington School of Medicine, Seattle
JAMA. 2013;310(24):2672-2673. doi:10.1001/jama.2013.282648.
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To the Editor Dr Sheffield and colleagues1 found that on a patient level, intraoperative cholangiography was associated with reduced risk of common bile duct injury during cholecystectomy, presumably by laying out a roadmap for the surgeon. This is consistent with other appropriately powered studies of the topic. A secondary, instrumental variable analysis was performed to control for the unmeasured confounding in this study based on administrative data, but it is unclear whether this was appropriate.

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December 25, 2013
Taylor S. Riall, MD, PhD; Kristin M. Sheffield, PhD; Yong-Fang Kuo, PhD
1Department of Surgery, University of Texas Medical Branch, Galveston
JAMA. 2013;310(24):2674. doi:10.1001/jama.2013.282657.
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