Laparoscopic Cholecystectomy
The gallbladder is a bile storage organ which is attached to the bottom surface of the liver. It stores bile which is an emulsifier for fat, and after a fatty meal, a hormone causes the gallbladder to contract, squeezing the bile into the common bile duct, the main bile duct, and from there into the first part of the small intestine, the duodenum. The problem with bile storage in some patients, particularly women who are over the age of 40, overweight and have had children, the stagnant bile can form gallstones. This can cause severe pain, and sometimes infection.
The modern way to remove a gallbladder is using the laparoscope. Small incisions are made into the abdomen, the gallbladder is grasped at its top surface, and the connection between the gallbladder and the common bile duct, the cystic duct, must be must be observed to be sure that the common bile duct is never injured. An injury to the common bile duct results in a serious lifelong disaster, with scarring and repetitive obstruction of bile flow, resulting in jaundice, liver failure, and sometimes infection.
In this case, the surgeon performed the laparoscopic cholecystectomy operation, but because of scar tissue down at the site between the gallbladder and common bile duct, it was difficult for him to see the cystic duct. Unfortunately, instead of performing an open procedure, which is an incision under the rib cage, a sub-costal incision, he continued onward and damaged the common bile duct.
The negligence of this general surgeon was his failure to stop with the laparoscopic procedure and perform an open operation, where direct vision makes the procedure much safer. He was negligent, and the damage to the common bile duct, which unfortunately he did not even recognize at that operation. He negligently placed a suture ligature around the common bile duct, mistaking it for the cystic duct, resulting in the need for a specialist to come and re-operate, but unfortunately, the common bile duct was permanently damaged, since repairs are often fraught with re-scarring, resulting in future serious life-threatening problems.
The experts necessary in this case are a general surgeon skilled in the laparoscopic cholecystectomy operation. If this defendant general surgeon was not experienced in the procedure, then the hospital itself would also be liable for allowing an inexperienced general surgeon to perform a complex operation on its premises. Also, a gastroenterologist would be required to testify to all the long-term complications that this patient faces over many years from the injury to her common bile duct. A psychologist and/or psychiatrist could also testify to the emotional injuries that this patient has undergone and will undergo in the future.
