Surgeon Negligently Severs Common Bile Duct During Laparoscopic Cholecystectomy

A Virginia man recently settled a case of medical negligence for $1.85 million dollars against his surgeon who, in the course of performing a laparoscopic cholecystectomy (also known as laparascopic gall bladder surgery), negligently severed his common bile duct. In the lawsuit, the plaintiff alleged that the defendant surgeon experienced difficulty dissecting and locating cystic duct due to what he thought was its unusually large diameter. Post-operatively, the plaintiff suffered abdominal distension and worsening pain over several hours. Radiology scans revealed the error. The plaintiff subsequently required biliary repair surgery and numerous bouts of cholangitis and elevated liver function tests. It is also believed he will require a future liver transplant as a result of the negligence.

Laparoscopic gallbladder surgery is one of the most common surgical procedures in the United States today. Bile is a caustic substance created in the liver that is necessary for digestion and the absorption of food in the small intestine. Bile normally flows from the liver down the right and left hepatic ducts, into the common hepatic duct and then into the cystic duct, and is stored in the gallbladder. When the digestive system signals the body that it needs bile to digest food, the gallbladder contracts and bile flows out of the gallbladder through the cystic duct and then down the common bile duct into the small intestine. Sometimes, small hard pieces called gallstones form in the gallbladder and interfere with the normal flow of bile. One remedy for gallstones is the removal of the gallbladder. Digestion and the absorption of food is unimpaired in patients even after removal of the gallbladder.

During a laparoscopic cholecystectomy, surgical clips are supposed to be placed across the cystic duct and the artery that supplies blood to the gallbladder. The cystic duct and artery are then divided between the clips, and the gallbladder is removed. At no time during the surgery should the common bile duct be clipped or cut, as it must remain intact so that the flow of bile between the liver and small intestine can still occur. If there is any question about the anatomy, the surgeon must visualize the entire bile duct system before cutting. Surgeons can easily perform an intraoperative cholangiogram to clearly show a detailed roadmap of the anatomy and/or convert from a laparoscopic procedure to an open procedure to get a better view of what he is cutting.

Nonetheless, sometimes an inexperienced or unskilled doctor will mistakenly cut the common bile duct or hepatic duct while believing that they are cutting the cystic duct. If errors such as these take place, extremely serious injuries or even death can occur. For example, if the bile duct is cut, a patient may leak bile into the abdominal cavity causing pain, breathing difficulties or infection. The error of cutting the wrong duct can easily be avoided, however, by the simple use of a a cholangiogram, an x-ray of the bile ducts that can be obtained intra-operatively to correctly determine what structures should be cut. In short, these errors / medical mistakes are preventable.

At STSW, our lawyers routinely handle these types of cases in the Baltimore and Washington D.C. area. If you or a loved one has suffered a serious injury at the hands of a surgeon performing a cholecystectomy, call our legal team for a free consultation at (410) 385-2225.