Laparoscopic Cholecystectomy Surgery Gone Awry Can Lead to Permanent Injury

In the early 1990s, health care providers pioneered an innovative surgical technique for patients requiring the removal of their gallbladder (“cholecystectomy”). In the years leading up to 1990, gallbladder surgeries were performed solely in what was known as an “open” manner whereby a patient’s abdomen was surgically opened in order to gain access to the gallbladder for the purposes of removing it. Beginning in 1991, the laparoscopic cholecystectomy replaced the open cholecystectomy as the first choice of treatment for gallstones and/or the inflammation of the gallbladder. A laparoscopic cholecystectomy only requires several small incisions in the abdomen to allow the insertion of operating ports (small tubes 5-10 mm in diameter), through which surgical instruments and a video camera are placed into the abdominal cavity. The camera operates to illuminate the surgical field and send a magnified image to a video monitor giving the surgeon an up-close view of the organs and surrounding tissues. After a patient is sedated, typically the surgeon will inflate the abdomen with carbon dioxide to create a suitable working space. The camera is then inserted and additional ports are created at other sites on the abdomen to permit the surgeon the ability to manipulate the surgical instruments in which ever direction is needed. The surgeon next works to identify the gallbladder and open what is known as the Triangle of Calot, a region created by the location of the cystic artery (the artery that connects the liver to the gallbladder), the cystic duct (through which bile flows out of the gallbladder) and the common hepatic duct. At that point, the cystic artery and cystic duct are clipped and cut, permitting the removal of the gallbladder. Although the surgery is very complicated and requires precise maneuvering by the surgeon, it can generally be accomplished within an hour or so.

Although the laparoscopic cholecystectomy is preferred to the open cholecystectomy because the latter technique leaves a patient more prone to developing an infection, results in greater blood loss and results in a longer recovery time, complications can still arise. One of the most unfortunate complications that can occur during a laparoscopic cholecystectomy is if the surgeon mistakenly lacerates or transects the wrong duct in the biliary tree. For example, many times, a surgeon has difficulty identifying the structure that he intends to clip and cut (the cystic duct and cystic artery). Sometimes this is due to the fact that the patient begins to bleed internally during the procedure, or sometimes it results from the fact that these structures are fused together. Regardless, the surgeon, under the standard of care, must as a cardinal rule, clearly identify the structure he is about to cut before he cuts it. If he does not, the complications can be catastrophic. If, for example, the surgeon accidentally cuts or transects the patient’s common bile duct or common hepatic duct, the patient will begin leaking bile in the abdominal cavity. If this goes unnoticed for a period of days, it can cause the patient to become ill or even septic. Even if the laceration or transection is ultimately identified, patients often require extensive surgical procedures to repair the damage, including the insertion of stents into the biliary ducts to cover over holes in the vessel. These stents and surgeries, in turn, often result in the patient developing “strictures” or blockages at the repair sites, requiring additional procedures to re-open the vessels. In the most severe cases, the laceration of the wrong structure can result in a patient’s liver starting to function improperly, sometimes even requiring a transplant. For these reasons, although the laparoscopic cholecystectomy is the surgery of choice for gallbladder removal, it is not without danger is the surgeon does not adhere to the standard of care in performing it.

If you or a loved one have suffered an injury following a gallbladder removal surgery, call our lawyers for a free consultation at (410) 385-2225.