Friday, November 9, 2007


Consult on a lady with "porcelain gallbladder" today. Traditional surgical dogma was that one should never attempt laparoscopic cholecystectomy in the presence of known porcelain gallbladder because of the high incidence of malignancy. (Concern about port site implants and adequacy of resection.) Recent literature however suggests that one oughn't to rush into open cholecystectomy. The incidence of invasive cancer in the setting of calcified gallbladder is actually much lower than originally thought. Therefore the morbidity of the open approach cannot be routinely justified. Everyone else practice similarly?

This is utterly astounding to me. $4.85 billion dollars? Amazing that the settlement can be considered a triumph for Merck. What does that say about their bottom line? Apparently, each individual will get a little less than $100,000 as a payout (BEFORE the lawyers get their cut.) Once again, the real winners seem to be the attorneys.

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