Calculating individual costs for minor and major bile duct injuries with actual incidences of cholecystectomies performed and the incidence of iatrogenic bile duct injury demonstrated that the total costs, including in-hospital cost, sick leave and loss of production, were substantial. For the management of minor bile duct injuries costs were within the range of 136,787-159,585 EUR and for the management of major bile duct injuries from 336,903-449,204 EUR per million inhabitants and year. The total costs for the management of all types of bile duct injuries were thus within the range of 473,690-608,789 EUR per million inhabitants annually for the society.

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We recently have shown that samples from microdialysis (MD) probes placed on the surface of the heart reflect metabolic events in the myocardium. This new interesting observation challenges us to consider whether surface application of MD applies to other parenchymatous organs and their surfaces. In 13 anesthetized pigs, transient liver ischaemia was achieved by occlusion of arterial and venous inflow to the liver. Two probes on liver surface and two in parenchyma were perfused with a flow rate of 1 μl per min (n = 13). An identical set-up was used for probes with a flow rate of 2 μl per min (n = 9). Samples were collected for every 15-min period during 60 min of baseline, 45 min of ischaemia and 60 min of reperfusion. Lactate, glucose, pyruvate and glycerol were analysed in MD samples. We focused on relative changes in the present study. There was a strong agreement in relative lactate and glucose levels between probes placed on liver surface and those on parenchyma. No significant differences in relative changes in lactate and glucose levels were seen between samples from surface probes and probes in liver parenchyma during equilibration, baseline, ischaemia or reperfusion with a flow rate of 1 μl per min. MD sampling applied on the liver surface is a new application area for the MD technique and may be used to monitor liver metabolism during both physiological and pathophysiological conditions.