Injuries during Laparoscopic Cholecystectomy: A Scoping Review of the Claims and Civil Action Judgements.

biliary injury laparoscopic cholecystectomy legal practice litigation postoperative complications

Journal

Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588

Informations de publication

Date de publication:
10 Nov 2021
Historique:
received: 03 10 2021
revised: 04 11 2021
accepted: 08 11 2021
entrez: 27 11 2021
pubmed: 28 11 2021
medline: 28 11 2021
Statut: epublish

Résumé

To define what type of injuries are more frequently related to medicolegal claims and civil action judgments. We performed a scoping review on 14 studies and 2406 patients, analyzing medicolegal claims related to laparoscopic cholecystectomy injuries. We have focalized on three phases associated with claims: phase of care, location of injuries, type of injuries. The most common phase of care associated with litigation was the improper intraoperative surgical performance (47.6% ± 28.3%), related to a "poor" visualization, and the improper post-operative management (29.3% ± 31.6%). The highest rate of defense verdicts was reported for the improper post-operative management of the injury (69.3% ± 23%). A lower rate was reported in the incorrect presurgical assessment (39.7% ± 24.4%) and in the improper intraoperative surgical performance (21.39% ± 21.09%). A defense verdict was more common in cystic duct injuries (100%), lower in hepatic bile duct (42.9%) and common bile duct (10%) injuries. During laparoscopic cholecystectomy, the most common cause of claims, associated with lower rate of defense verdict, was the improper intraoperative surgical performance. The decision to take legal action was determined often for poor communication after the original incident.

Sections du résumé

BACKGROUND BACKGROUND
To define what type of injuries are more frequently related to medicolegal claims and civil action judgments.
METHODS METHODS
We performed a scoping review on 14 studies and 2406 patients, analyzing medicolegal claims related to laparoscopic cholecystectomy injuries. We have focalized on three phases associated with claims: phase of care, location of injuries, type of injuries.
RESULTS RESULTS
The most common phase of care associated with litigation was the improper intraoperative surgical performance (47.6% ± 28.3%), related to a "poor" visualization, and the improper post-operative management (29.3% ± 31.6%). The highest rate of defense verdicts was reported for the improper post-operative management of the injury (69.3% ± 23%). A lower rate was reported in the incorrect presurgical assessment (39.7% ± 24.4%) and in the improper intraoperative surgical performance (21.39% ± 21.09%). A defense verdict was more common in cystic duct injuries (100%), lower in hepatic bile duct (42.9%) and common bile duct (10%) injuries.
CONCLUSIONS CONCLUSIONS
During laparoscopic cholecystectomy, the most common cause of claims, associated with lower rate of defense verdict, was the improper intraoperative surgical performance. The decision to take legal action was determined often for poor communication after the original incident.

Identifiants

pubmed: 34830520
pii: jcm10225238
doi: 10.3390/jcm10225238
pmc: PMC8622805
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

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Auteurs

Roberto Cirocchi (R)

Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy.

Laura Panata (L)

Legal Medicine and Insurance Office, Santa Maria della Misericordia Hospital, 06129 Perugia, Italy.

Ewen A Griffiths (EA)

Department of Upper Gastrointestinal Surgery, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Trust, Birmingham B15 2GW, UK.
Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK.

Giovanni D Tebala (GD)

Surgical Emergency Unit, John Radcliffe Hospital, Oxford University NHS Foundation Trust, Oxford OX3 9DU, UK.

Massimo Lancia (M)

Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy.

Piergiorgio Fedeli (P)

School of Law, Legal Medicine, University of Camerino, 62032 Camerino, Italy.

Augusto Lauro (A)

Department of Surgical Sciences, Hospital "Policlinico Umberto I", "Sapienza" University of Rome, 00161 Rome, Italy.

Gabriele Anania (G)

Department of Medical Science, University of Ferrara, 44121 Ferrara, Italy.

Stefano Avenia (S)

Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy.

Salomone Di Saverio (S)

Department of General Surgery, ASUR Marche, AV5, Hospital of San Benedetto del Tronto, 63074 San Benedetto del Tronto, Italy.

Gloria Burini (G)

Department of General and Emergency Surgery, Hospital "Ospedali Riuniti di Ancona", 60126 Ancona, Italy.

Angelo De Sol (A)

Department of General Surgery, St. Maria Hospital, 05100 Terni, Italy.

Anna Maria Verdelli (AM)

Legal Medicine and Insurance Office, Santa Maria della Misericordia Hospital, 06129 Perugia, Italy.

Classifications MeSH