Negligent Gall Bladder Surgery
Post Surgical Detection of Errors
Gall bladder removal, better known as a cholecystectomy, is a typical keyhole or laparoscopic operation. Typically this is an outpatient operation, which allows the patient home on the day of surgery or very soon thereafter. There is a recovery period of about 4-8 weeks depending upon the patient.
What Goes Wrong?
In most cases nothing, the procedure is not easy though, it requires blind operation techniques and it is not without risk, however, almost all operations are completely successful. However, inevitably errors can occur. As a procedure there is a requirement to fit surgical clips, the surgeon clips the cystic duct in two places. One is near the cystic duct’s juncture with the gallbladder, and the second is at the cystic duct’s juncture with the common bile duct. The surgeon similarly also clips the cystic artery.
The surgeon then transects (cuts) the cystic duct and artery between the two clips. By transecting the cystic duct and artery, the surgeon releases the gall bladder for removal from the abdominal cavity. It's a lot easier to say than it is to do.
The surgeon must find and identify the cystic duct’s juncture with the gall bladder and the cystic duct’s juncture with the common bile duct before transecting the cystic duct. The surgeon achieves this by finding the gall bladder and the cystic duct juncture; and then meticulously tracing the cystic duct to its junction with the common bile duct.
The objective is to identify the cystic duct conclusively. The surgeon must not clip the cystic duct or transect it before making conclusive identification of the cystic duct.
The most common area for fault as you can probably guess, is that the surgeon clips or cuts the patient’s common bile duct instead of the cystic duct. This injury usually requires extensive, complicated and painful surgery to reconstruct the patient’s biliary system.
The biggest issue here is often the patient is actually discharged without a recognition that the injury has occurred. Once the injury is diagnosed, the patient is often in extreme pain and discomfort. Once the patient’s biliary anatomy has been reconstructed, there will be a long period of convalescence. If the patient is not diagnosed quickly the results can often be fatal.
Often the litigation in which we are involved focuses on that one issue - that the surgeon failed to conclusively identify the cystic duct and or did not diagnose the injury caused by that failure.
As a result, the surgeon may have placed clips across the common bile duct, obstructing the flow of bile or transected the patient’s common bile duct, resulting in the flow of bile into the patient’s abdomen with consequent sepsis.
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