Surgical Accidents

Laparoscopic Cholecystectomy and Increased Risk of Bile Duct Injury (continued)

First and foremost, if the doctor doesn’t have a clear view of the tissue they are about to divide, they should not divide the tissue. If the patient, because of their unique anatomy and shape is a difficult case, they should be converted to an open procedure.

Though it is true that there is much in the way of surgical literature suggesting that injury to a common bile duct is an “accepted complication” of the procedure, the statements are simply not true. It is true that injury to the common bile duct is a known complication of the performance of either an open or closed cholecystectomy. There is almost always a reason why such injuries occur and the injuries when they occur are often due to medical malpractice.

Injured bile ducts are not inconsequential complications. Even when promptly recognized and repaired, the injury to the common bile duct or common hepatic duct can result in a narrowing of the duct which can cause obstruction of the flow of bile out of the liver. The worse case scenario is the patient who ultimately requires a liver transplant because of a needless injury high in the biliary system during the course of a laparoscopic cholecystectomy. There are anatomical variations of bile ducts and blood vessels which may excuse the occurrence of a bile duct injury in a given case, but in general, an injury to the bile duct occurring during the course of a laparoscopic cholecystectomy, which injury results in recurring problems with the potential for permanent liver damage should be considered a case of possible medical negligence until proven otherwise.

Author: Jerry I. Meyers.

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