A prospective trial indicates a new ultrasound technique may improve detection of bile leaks during liver surgery.

• Contrast-enhanced intraoperative ultrasonic cholangiography was technically successful in 86.2% of patients.
• Postoperative bile leak rate was 17.2%, with most detected intraoperatively.

This approach could enhance surgical safety but requires further validation to confirm its impact on patient outcomes.

• No adverse events related to the injection were reported, and postoperative liver enzyme elevations were lower than historical standards.