Editorial opinion
Major common bile duct injury and risk of litigation: a surgeon's perspective

https://doi.org/10.1016/j.amjsurg.2011.06.009Get rights and content

Abstract

Risk for a lawsuit for medical malpractice has unfortunately become part of physicians' daily professional activities, with a blowout in indemnity insurance premiums, especially in high-risk medical specialties. Common bile duct injury following laparoscopic cholecystectomy is a well-recognized and feared complication for surgeons because of its associated morbidity, and it also ranks among the leading sources of medical malpractice claims against surgeons in the world. The purpose of this article is to raise awareness within the medical community and in particular among specialist surgeons on the important threat they could be facing in terms of litigation in the event of an adverse surgical outcome following such a commonly performed procedure. There is a real need for open debate on this concerning topic, as the fear of lawsuits and exorbitant malpractice premiums are pushing a substantial number of medical professionals to practice defensive medicine, reflected by the avoidance of performing certain procedures or treating high-risk patients perceived to have higher litigation rates, or simply walking away from their current practices, creating a chronic shortage of specialized doctors in certain surgical areas.

References (11)

  • A. Shamiyeh et al.

    Laparoscopic cholecystectomy: early and late complications and their treatment

    Langenbecks Arch Surg

    (2004)
  • N.N. Massareh et al.

    Role of intraoperative cholangiography in avoiding bile duct injury

    J Am Coll Surg

    (2007)
  • S.B. Archer et al.

    Bile duct injury during laparoscopic cholecystectomy: results of a national survey

    Ann Surg

    (2001)
  • L.W. Way et al.

    Causes and prevention of laparoscopic bile duct injuries: analysis of 252 cases from a human factors and cognitive psychology perspective

    Ann Surg

    (2003)
  • D.R. Flum et al.

    Bile duct injury during cholecystectomy and survival in Medicare beneficiaries

    JAMA

    (2003)
There are more references available in the full text version of this article.

Cited by (27)

  • Use of fluorescence imaging and indocyanine green during laparoscopic cholecystectomy: Results of an international Delphi survey

    2022, Surgery (United States)
    Citation Excerpt :

    In fact, BDI incidence increased,3,4 with the absence of tactile sensation and visual misperceptions secondary to the new optoelectronic instrumentation commonly implicated as responsible.2,5,6 Irrespective of efforts to develop safer laparoscopic techniques for cholecystectomy and cholangiography and increased surgeon awareness, 30 years after LCs first were introduced, BDI incidence remains unacceptably high.7–10 Indocyanine green (ICG) is a fluorophore that responds to near-infrared irradiation, absorbing light between the wavelengths of 790 and 805 nm and re-emitting it with an excitation wavelength of 835 nm.11

  • Impact of iatrogenic biliary injury during laparoscopic cholecystectomy on surgeon's mental distress: a nationwide survey from China

    2020, HPB
    Citation Excerpt :

    LC-IBI is a well-recognized and feared complication for surgeons because of its associated morbidity. It also ranks among the leading causes of medical malpractice claims and lawsuit litigations against surgeons in the world.17,28 Previous studies have suggested medical dispute and lawsuit litigation would lead to emotional tension and mental distress of doctors.29–31

  • Fluorescence imaging of the biliary tree with indocyanine green

    2020, Strategies for Curative Fluorescence-Guided Surgery of Cancer
View all citing articles on Scopus
View full text